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Biomedical subjects

F J Silvestre

Publications and source records attributed to F J Silvestre.

14 recordsLinked to original sources
PubMed2005

Avascular jaw osteonecrosis in association with cancer chemotherapy: series of 10 cases.

BACKGROUND: We present a series of 10 patients with osteonecrosis of the jaws (ONJ) that appeared following cancer chemotherapy. MATERIAL AND METHODS: Of the 10 cases with ONJ, six had bone metastases from breast cancers and the other four had multiple myeloma. We analysed the location of bone metastases, as well as the characteristics of the ONJ, and the drugs with which they had been treated for their bone metastases. RESULTS: Of the 10 patients, all had ONJ in the mandible; 50% also had maxillary involvement. The average number of areas of painful exposed was 2.1 per patient (range 1-5). In seven patients a tooth extraction preceded the onset of ONJ. Two patients developed oroantral communications and another a cutaneous fistula to the neck with suppuration. In all the 10 patients the histopatholological diagnosis was of chronic osteomyelitis without evidence of metastatic disease to the jaws. All the patients had received treatment for their malignant bone disease with bisphosphonates. These were the only drugs that all patients had received. CONCLUSION: ONJ appears to have a relationship with the use of bisphosphonates.

Adult↗
PubMed2003

Oral lesions in recessive dystrophic epidermolysis bullosa.

OBJECTIVE: To study the prevalence of oral lesions in 35 patients diagnosed with generalized recessive dystrophic epidermolysis bullosa (RDEBg), with a quantification of their microstomia in comparison with a control group. MATERIAL AND METHODS: The presence of oral mucosal lesions and interincisal maximum oral aperture (MOA) was determined, classifying microstomia according to the method of Naylor, Douglass and Mix (1984). RESULTS: Blister lesions were identified in 92% of the patients at the time of exploration--the tongue being the most affected location. Microstomia and palatal atrophy were the most prevalent sequelae (100%), while ankyloglossia, vestibular obliteration and lingual depapillation were recorded in over 90%. In 80% of the patients interincisal MOA was <30 mm (severe microstomia), while in the remaining cases maximum aperture was in the range of 31-40 mm (moderate microstomia). CONCLUSIONS: Blister lesions were found throughout the oral mucosa in our series of patients with RDEBg, the most frequently affected location being the tongue. These lesions in turn led to invalidating sequelae such as microstomia and ankyloglossia.

Adolescent↗
PubMed2000

Cluster headache and cocaine use.

We present 3 patients who had episodes of orofacial pain compatible with cluster headache, the differential diagnosis being established with pulp pain of dental origin. Cocaine inhalation triggered pain in the premolar zone of the upper jaw, followed by spread of pain to the periorbital region on the same side. The pain episodes were very intense and lasted between 30 and 120 minutes. The patients presented conjunctival injection and lacrimation of the affected eye during these episodes. The crises were always unilateral. In one patient, pain shifted sides from one crisis to another within the same symptomatic or cluster period, affecting the side through which the drug was inhaled. Pain usually appeared 1 to 2 hours after cocaine consumption, though it disappeared 5 to 10 minutes after again inhaling the drug. None of our patients acknowledged cocaine consumption at the first visit; drug inhalation was only admitted at subsequent visits, once a degree of confidence had been established with the physician.

Administration, Inhalation↗
PubMed2000

Placement of endosseous implants in patients with oral epidermolysis bullosa.

OBJECTIVE: To evaluate the feasibility of placing endosseous implants in patients with recessive dystrophic epidermolysis bullosa. This article reports on 4 patients subjected to follow-up. STUDY DESIGN: Implants were placed in 4 cases. All patients have marked oral involvement, with devastating alterations in the soft and hard tissues in all cases. RESULTS: A total of 15 implants (7 maxillary, 8 mandibular) were placed. All implants integrated successfully and have been restored. The average follow-up from implant placement was 2.5 years (range, 1-4). CONCLUSIONS: Our preliminary findings suggest that endosseous implants can be successfully placed and can provide support for prosthetic restoration in patients with recessive dystrophic epidermolysis bullosa.

Adult↗
PubMed1994

Prevalence of psychopathology in burning mouth syndrome. A comparative study among patients with and without psychiatric disorders and controls.

Forty-nine patients with burning mouth syndrome were simultaneously evaluated through a psychiatric interview and a psychopathologic questionnaire (SCL-90). The same protocol was applied to a control group (n = 47) free of oral complaints and with a similar age and sex distribution. The subgroup with burning mouth syndrome and associated psychiatric disorders differed from the subgroup of patients without psychiatric disorders in that the former exhibited significantly more symptoms of anxiety, depression, obsession, somatization, and hostility. This latter parameter appears to be present particularly among depressed persons. No significant psychopathologic differences were observed between the subgroup with BMS who exhibited no psychiatric disorders and the controls who were free of oral disorders.

Anxiety Disorders↗
PubMed1993

Psychiatric morbidity in burning mouth syndrome. Psychiatric interview versus depression and anxiety scales.

Seventy-four patients with burning mouth syndrome underwent a psychiatric interview; Hamilton's Depression and Anxiety Scales were applied independently. A psychiatric diagnosis was established in 38 cases (51.35%). Depression was the predominant disorder. The evaluation scales showed that when present, anxiety greatly influences the psychiatric condition of these patients. The differences in the results obtained with the two methods are discussed.

Anxiety Disorders↗
PubMed1991

Recurrent aphthous stomatitis. A study of the clinical characteristics of lesions in 93 cases.

We studied the clinical characteristics of 93 patients with recurrent aphthous stomatitis (RAS); 66 corresponded to minor aphthae (MiRAS), 20 to major aphthae (MaRAS), and 7 to herpes-like ulcerations (HU). MiRAS was seen to present the lowest rate of recurrences, as well as the shortest duration and the fewest lesions per episode. In turn, MaRAS presented the longest duration per recurrence, along with a number of lesions and recurrences that was lower than in HU but greater than in cases of MiRAS. Finally, HU developed the greatest number of lesions and recurrences. When we classified RAS according to the rate of episodes, no statistically significant differences were observed among the three types in terms of patient age, number and duration of lesions, or evolution time of the oral disorder.

Adult↗
PubMed1990

[Oral status of drug addicted patients. Study of 66 cases].

We studied 66 heroin-addicted patients from Valencia Community, comparing them with a control group of 30 healthy subjects. In all cases the CAO index and gingival state were analysed, including possible pathology of oral mucous. It was revealed that the major oral deterioration was in the experimental group. This was directly related to oral hygiene deficiency, which was brought about in the period of active addiction. At the same time the difference in oral mucous pathology between the two groups was not significant.

Adult↗
PubMed1985

Treatment of lichen planus with griseofulvin. Report of seven cases.

Seven patients with lichen planus of the oral mucosa (four with erosive and three with reticular types of the disease) were studied; they were treated with 500 mg of griseofulvin twice daily for 2 1/2 months. In no case was improvement observed; on the contrary, in four patients (two with erosive and two with reticular forms) the condition worsened.

Adult↗
PubMedDate not supplied

Effects of vasoconstrictors in dentistry upon systolic and diastolic arterial pressure.

INTRODUCTION: Vasoconstrictors associated to local anesthetics habitually used in dental practice have been reported to influence arterial pressure, in the same way as other factors such as patient anxiety or stress. OBJECTIVES: The present study investigates the variations in systolic and diastolic arterial pressure in three groups of patients subjected to conventional dental treatment in the form of molar extraction, with the aim of determining whether such variations are attributable to the use of a vasoconstrictor or to other factors such as patient anxiety. MATERIALS AND METHODS: A total of 43 healthy males with normal blood pressure readings were grouped according to the type of anesthetic solution employed: Group I (2% lidocaine with epinephrine 1:80,000), Group 2 (3% mepivacaine with epinephrine 1:100,000) and Group 3 (3% mepivacaine with no associated vasoconstrictor). In all cases the Hamilton Anxiety Scale was applied, with blood pressure recordings before and after anesthetic injection, during dental extraction, and at the end of treatment. RESULTS: No statistically significant differences were observed in the blood pressure variations among the groups according to whether or not a vasoconstrictor was associated to the anesthetic solution in these healthy subjects. In increased systolic pressure was observed during extraction in all three study groups. CONCLUSION: Our findings suggest that the use of a vasoconstrictor in association to the local anesthetic solution does not substantially modify blood pressure. On the other hand, the observed increase in systolic pressure in all three treatment groups may be attributed to patient anxiety.

Adult↗
PubMedDate not supplied

Dental management of the patient with ischemic heart disease: an update.

Ischemic heart disease is the most common cause of death in developed countries. The classical protocols for providing dental care in these patients with chest angina or myocardial infarction were based on the classification of the American Society of Anesthesiologists (ASA), postponing therapy for a minimum of 6 months after infarction in order to ensure safer dental treatment. However, advances in diagnostic techniques and medical and surgical treatments in patients with heart disease have led to the development of more precise risk assessment protocols, thus allowing earlier post-infarction dental treatments and oral surgery, with acceptable safety margins.

Dental Care↗
PubMedDate not supplied

Melatonin: implications at the oral level.

The strong relationship between the pineal gland and the immune system continues to establish itself more and more. In situations of a pinealectomy or in those of inhibition of the production of melatonin, a state of immunosuppression is produced which disappears when the patient receives this hormone. Likewise, melatonin counteracts the negative effects that immunosuppressive drug treatment produce over the immunity. It is due to these facts that one postulates the possibility of utilizing melatonin in primary and secondary immunodeficiency states as well as in cancerous immunotherapy. The action of this hormone over the immune system is carried out through the T-helper lymphocytes, lymphokines and also it seems through certain pituitary hormones. On the other hand, lymphokines such as gamma-interferon and interleukin-2, as well as the thymus, can modulate the synthesis of melatonin at the level of the pineal gland. Without doubt, all these actions have important consequences at the time of treatment of our high-risk dental patients who have, in one way or another, an altered immunologic system. The altered immune system has direct implications in primary oral pathologies, or in others derived directly from our dental treatment.

Adjuvants, Immunologic↗