Campisi, G.

DI FEDE, O.

Giancola, F.

Giannatempo, G.

Lo Muzio, L.

Mauceri, R.

Giancola, Francesco

DI FEDE, Olga

Mauceri, Rodolfo

CAMPISI, Giuseppina

Archivio istituzionale della ricerca - Università di Palermo

Vol. 65 - Suppl. 1 to No. 3 MINERVA STOMATOLOGICA 201locations (G1: 79,27% single and 20,73% multiple, G2: 75% and 25%).For SA, taking into account the clinical improvement and complete healing, interesting results were highlighted compar-ing T1 vs T2 (29,4% vs 56,81%, 23,5% vs 31,81%), T1+T2 vs T3+T4+T5 (49,18% vs 87,82%, 29,50% vs 81,74%) and T3 vs T4+T5 (50% vs 92,23%, 50% vs 85,44%).Results comparing an early approach (stage I) vs therapies in stage II and III lled almost twice as much to stage 0 (80% vs 57,14%)CONCLUSIONS: In SB no differences between non surgical and surgical approach were highlighted.In both groups the use of laser significantly improves the out-come of treatments.Surgical laser approach in Stage III led to complete healing in all cases.Early surgical approach leads in almost every cases to a com-plete healing.Further studies are needed to test if the suspension of the administration of drugs could lead to higher percentage of improvement and/or healing in patients treated through Zoledronic acid combined with antiresorptive-antiangiogenic drugs or antiresorptive-antiangiogenic drugs only.Oral manifestations in immunodeficient patients G. Ghilardi, C. Ciuffreda, M. Marcolina, L. Simone, A. Bandel, A. Liguori, A. Lucchese, G. Gastaldi, E. P. GherloneDepartment of Orthodontics, Unit of Dentistry, Vita Salute San Raffaele University, IRCCS, San Raffaele Hospital, Milan, ItalyBACKGROUND: The oral cavity is an anatomical structure characterized by the juxtaposition of soft and hard tissues, and is continuously threatened by the external environment and foreign materials. Diseases and disorders caused by oral microorganisms are very common, particularly dental car-ies, periodontitis and halitosis. Oral diseases can also arise in the setting of a systemic compromission due to immuno-deficiency, whose clinical importance is becoming more and more outstanding. In such conditions, oral manifestations may be more frequent, or even more severe. The aim of this study is to highlight oral and more specifically orthodontic mani-festations shared by individuals with immunodeficiencies, so that precautions that will improve patients’ quality of life, especially in regard to dental aspects, may be established in the future.METHODS: A group of subjects (11 males and 9 females, mean age 12-20 years) was selected from patients with immu-nodeficiencies who referred to the Immunohaematology Department of San Raffaele Scientific Institute in Milan, Italy, between 2010 and 2015. All these subjects underwent the following iter: laboratory tests, microbiological, haema-tological and immunological evaluation, brain MRI, brain CT, orthopantomography and oral examination, hand–wrist radiography BACKGROUND:ed at evaluating the effects of pathologies of the immune system on patients’ growth.RESULTS: Medical signs and symptoms which are charac-teristic of peculiar immunodeficiency syndromes, such as recurrent infections, eczema, thrombocytopenia, anaemia, petechiae, ecchymosis, mucosal bleeding and major bleed-ing, were usually observed. The oral examination revealed gingivitis, periodontitis, aphthous lesions, gingival bleeding, petechiae in the oral mucosa, severe oral infections (caries, pulpitis, abscesses). As for orthodontic aspects, we found a higher incidence of alterations in the physiological erup-tive sequence, i.e. inclusions and transpositions, probably caused by untreated inflammatory and infectious processes. Infections affecting permanent teeth may also result in mal-occlusion, which possibly paves the way for future skeletal problems. In addition to that, immunodeficiency may compro-mise orthodontic treatments and interfere with their purpose of aligning teeth and solving skeletal issues.CONCLUSIONS: Since immunodeficiencies comprise a wide spectrum of symptoms and complications, it is mandatory to increase awareness of this entity. Although little attention was dedicated to this matter in the literature, a multidisciplinary approach for the treatment of these patients should always include the dentist, whose role is to intercept pathologies of the oral cavity and ultimately improve their quality of life.Early onset ONJ in patient treated with deno-sumab and bevacizumab: case reportF. Giancola 1, O. Di Fede 1, G. Giannatempo 2, L. Lo Muzio 2, R. Mauceri 1, G. Campisi 1¹Department of Surgical, Oncological and Oral Sciences, Uni-versity of Palermo, Palermo; ²Department of Clinical and Ex-perimental Medicine, University of Foggia, FoggiaBACKGROUND:Osteonecrosis of the jaw (ONJ) is a no longer serious com-plication related to many drugs, notoriously aminobisphos-phonate (BP) but also antiresorptives and anti-angiogenetics. Several cases of denosumab-related ONJ have been reported and the overall incidence is similar to that for BP-related ONJ. It is known that, concomitant administration of two or more of these drugs increase considerably the risk of onset and sever-ity of ONJ.We describe a case report of early onset ONJ in oncologic patient treated with denosumab and bevacizumab, with nega-tive anamnesis for BP administration.METHODS: In March 2015, a 58-year-old female patient was referred to our department for pain and swelling of upper left maxilla.Patient reported the following anamnestic data: in 2010, for the diagnosis of breast cancer, she was underwent to right quadrantectomy surgery and radiant treatment; she was treated with monthly subcutaneous injections of 120 mg denosumab (eight doses from April 2014 to November 2014) and bevaci-zumab (five doses from August 2014 to November 2014); she had no history head and neck radiotherapy and BP administra-tion. One trigger (local risk factor for ONJ) has been recog-nized: extractions of maxillary left second premolar and first molar have been performed few months before.Intraoral examination showed a painful area of bone exposure in the left posterior maxilla and erythematous soft tissue with purulent discharge and swelling was detected.After OPT and CBCT scans, bone necrosis was classified as stage II, according to Bedogni et al.Systemic antibiotic (ampicillina/sulbactam intramuscularly twice daily for 8 days and metronidazole (off-label use) 250 mg orally twice daily for 8 days), local antiseptics (chlo-rhexidine 0.2% mouth rinses and 0.5% chlorhexidine gel) were administered. The patient was referred to Oral and Maxillofacial surgery for surgical management.CONCLUSIONS: It is widely described in literature that early-onset ONJ is more hazardous in oncologic patients, MINERVAMEDICACOPYRIGHT®This document is protected by international copyright laws.No additional reproduction is authorized.It is permitted for personal use to download and save only one file and print only one copy of this Article.It is not permitted to make additional copies(either sporadically or systematically, either printed or electronic) of the Article for any purpose.It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any othermeans which may allow access to the Article.The use of all or any part of the Article for any Commercial Use is not permitted.The creation of derivative works from the Article is not permitted.The production of reprints for personal or commercial use isnot permitted.It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article.It is not permitted to frame or use framing techniques to enclose any trademark, logo,or other proprietary information of the Publisher.ABSTRACT 202 MINERVA STOMATOLOGICA June 2016particularly when taking BP plus another ONJ-related drug. It is our opinion that it is necessary to give attention for pre-vention protocols also to the patients in therapy with all drugs related to ONJ. Overexpression of Nicotinamide n-Methyl-transferase in HSC-2 OSCC cell line: effect on apoptosis and cell proliferation.G. Giannatempo1, M. Mascitti2, O. Di Fede3, R. Mauceri3, A. Santarelli2, R. Seta2, D. Sartini2, R. Campagna2, M. Emanuelli2, L. Lo Muzio11Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; 2Department of Clinical Specialistic and Dental Sciences, Polytechnic University of Marche, Anco-na, Italy; 3Department of Surgical, Oncology and Oral Sciences - Sector of Oral Medicine, Palermo University, Palermo, ItalyBACKGROUND: The oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, representing up to 90% of oral cavity cancers. In the last decades, despite progress in therapeutic strategies of OSCC, the 5-year survival rate showed no significant improvement, remaining slightly below 50%.Nicotinamide N-Methyltransferase (NNMT) is a drug-metabolizing enzyme that is overexpressed in several tumors, including OSCC. In particular, NNMT overexpression in OSCC inversely correlates with lymph node metastasis, pT, pathological staging and histological grading. In addition to the potential role of NNMT as a prognostic factor, the mea-surement of salivary NNMT could serve as biomarker for ear-ly diagnosis of OSCC. In this study, in order to further explore the biological function of NNMT in OSCC cell metabolism, we investigated the effects of plasmid-mediated overexpres-sion of NNMT in OSCC cell line.METHODS: Human oral cancer cell line HSC-2 was trans-fected with the pcDNA3-NNMT plasmid. Control cells were transfected with the empty vector (pcDNA3) or treated with transfection reagent only (mock). Real-Time PCR, Western blot, and HPLC assay were used to evaluate NNMT expres-sion, both at mRNA and protein levels. The assessment of cell proliferation was performed with MTT colorimetric assay. Furthermore, the effect of NNMT upregulation on β-catenin, survivin, and Ki-67 expression was also investigated. Data were analyzed using GraphPad Prism software. Differences between groups were determined using the Kruskal-Wallis test.RESULTS: Compared with mock and pcDNA3-treated, cells transfected with pcDNA3-NNMT displayed significantly increased NNMT expression levels. Real-Time PCR showed a significant NNMT upregulation, that was confirmed at protein level by Western blot analysis. Furthermore, NNMT specific activity was significantly higher in transfected cells compared with controls. The results of MTT colorimetric assay showed that pcDNA3-NNMT plasmid was able to increase cell growth of HSC-2 cells compared with controls.In order to explore the potential involvement of NNMT in cellular pathways, such as apoptosis, cell proliferation and cell signaling, we examined whether NNMT overexpression was able to affect the expression of β-catenin, survivin, and Ki-67.The results seem to indicate a statistically significant upregu-lation of survivin ǻEx3 isoform in pcDNA3-NNMT plasmid transfected cells, while the expression of 3B and 2α survivin isoforms was not detectable. CONCLUSION: Our results show that NNMT overexpression in OSCC cell line significantly increases cell growth. The effect on the antiapoptotic survivin ǻEx3 isoform seems to suggest a possible involvement of NNMT in the proliferation and tumorigenic capacity of OSCC cells.Prognostic value of mithocondrial DNA analysis in patients with secondary oral squamous cell carcinomaD. B. Gissi, L. Sozzi, L. Luccarini, C. Amadasi, S. Kavaja, D. Servidio, L. Alessi, A. GabusiDepartment of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, BolognaBACKGROUND: In head and neck oncology a novel clas-sification of the secondary tumors was recently proposed on the basis of the clonal analysis of the tumors and the genetically altered mucosal field. Second neoplastic lesions can be classified as: Second Primary Tumors (SPTs) inde-pendent from the index tumor at the molecular level, Local Recurrences (LRs) or metastases that are instead related to the primary tumor and ‘‘second field tumors” (SFTs), derived from the same genetically altered mucosal field as the primary tumor. The distinction between LR, SPT and SFT is not a simply problem of classification but may influence prognosis and the choice of treatment. mtDNA (D-loop) sequence analysis was proposed in previous stud-ies as a reliable method for establishing the clonal relation-ship between two neoplastic manifestations. In the present study mtDNA D-loop analysis was applied in a group of consecutive patients experiencing a second loco-regional neoplastic manifestation after surgical resection of a primary Oral Squamous Cell Carcinoma (OSCC). The purpose was to evaluate differences in terms of survival rate between LRs, SPTs and SFTs.METHODS: The study population consisted of 24 patients who experienced a second neoplastic lesion after a surgical resection of a primary OSCC. 21/24 (87,5%) were limited to the oral cavity whereas 3/24 (12,5%) presented a neck nodal metastasis (LNM) as second event. mtDNA D-loop analysis was performed by deep sequencing and phylo-genetic clusterization in all index OSCCs, in all second-ary events and in respective normal mucosa. Disease-free survival endpoints was defined as the duration between appearance of second neoplastic lesion and dead of disease or last follow-up visit.RESULTS: mtDNA analysis showed 7/24 second neoplas-tic events (31,1%) phylogenetically related to index OSCC, and 17/24 cases (68,9%) phylogenetically independent. The genetic distinction of secondary tumours in LR, SPT and SFT was acquired on the basis of the phylogenetic relationship between normal mucosa of index OSCC and normal mucosa of secondary OSCC. All 7 clonal paired tumours showed respective normal mucosa phylogenetically related, suggest-ing a genetic diagnosis of LR. Among non clonal patients 3 out of 17 presented respective normal mucosa phylogeneti-cally related, suggesting a genetic diagnosis of SPT whereas in remaining 14 out of 17 non clonal paired lesions also the respective normal mucosa resulted phylogenetically distant entities suggesting the presence of an altered mucosal field and a genetic diagnosis of SFT. The presence of an altered mucosal field in non clonal patients resulted a variable signifi-cantly related with a better survival rate (p<.05), indeed 2/17 (11,8%) SFTs events failed as compared to 5/7 LR. (71,4%) and 3/3 SPTs (100%). INERVA MEDICACOPYRIGHT®This document is protected by international copyright laws.No additional reproduction is authorized.It is permitted for personal use to download and save only one file and print only one copy of this Article.It is not permitted to make additional copies(either sporadically or systematically, either printed or electronic) of the Article for any purpose.It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any othermeans which may allow access to the Article.The use of all or any part of the Article for any Commercial Use is not permitted.The creation of derivative works from the Article is not permitted.The production of reprints for personal or commercial use isnot permitted.It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article.It is not permitted to frame or use framing techniques to enclose any trademark, logo,or other proprietary information of the Publisher.

Early onset ONJ in patient treated with denosumab and bevacizumab: case report

https://iris.unipa.it/retrieve/handle/10447/179379/298520/Early%20onset%20ONJ%20in%20patient%20treated%20with%20denosumab%20and%20bevacizumab%20-%20case%20report.pdf

Early onset ONJ in patient treated with denosumab and bevacizumab: case report

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