1:	Med Oral. 2004 Aug; 9(4): 273-279
	[Protocol for the clinical management of dry mouth]
	[Article in English, Spanish].
	Silvestre-Donat FJ, Miralles-Jorda L, Martinez-Mihi V.
	Prof. F J Silvestre, Unidad de odontologia medico-quirurgica Clinica Odontologica Universitaria, C/ Gasco Oliag 1, 46010-Valencia, E-mail: francisco.silvestre@uv.es
	Dry mouth is a very common condition in dental practice, and the causes underlying this alteration in salivary secretion are diverse. The problem is particularly common in polymedicated elderly people. Treatment should aim to eliminate the background cause; however, when this is not possible, management should focus on the stimulation of salivation or the provision of a saliva substitute. The present study provides a systematic account of the management protocol for patients with dry mouth.

2:	Med Oral. 2004 Aug; 9(4): 280-287
	[Orofacial infections of odontogenic origin]
	[Article in English, Spanish].
	Gutierrez-Perez JL, Perea-Perez EJ, Romero-Ruiz MM, Giron-Gonzalez JA.
	Prof. Dr. Jose Luis Gutierrez Perez, Facultad de Odontologia. Universidad de Sevilla, C/ Avicena s/n, 41009 - Sevilla. E-mail: jlgp@us.es
	The polymicrobial nature of the odontogenic infections as well as the variety of associated conditions are a consequence of the diversity of the buccal microbiota and the anatomical and functional complexity of the oral cavity. In addition to this, all these processes can give way to multiple complications which range from the local to the systemic level. The appropriate choice of antibiotic and posology is crucial in the successful management of these infections. Pharmacodynamics provides those parameters that make it possible to assess how antibiotics activity varies in time. As a general rule, the first step in the initial management of orofacial infections in adults, included odontogenic infections, will be the administration of 875 mg of amoxicillin and 125 mg of clavulanic every 8 hours. Therapeutic compliance is paramount to avoid resistance, therefore patient acceptance must be sought. In this sense, it has been proved that Augmentine Plus (2000/125) every twelve hours both as profylaxis and as treatment significantly decreases the rate of infective complications associated to extraction of the third molar.

3:	Med Oral. 2004 Aug; 9(4): 288-292
	[DNA microarrays in oral cancer]
	[Article in English, Spanish].
	Otero-Rey E, Garcia-Garcia A, Barros-Angueira F, Torres-Espanol M, Gandara-Rey JM, Somoza-Martin M.
	Dr. Abel Garcia Garcia, Facultad de Odontologia, Calle Entrerrios s-n, 15705- Santiago de Compostela, Spain. E-mail: ciabelgg@usc.es
	One of the principal aims of modern cancer research is to identify markers allowing individual prediction of prognosis or response to treatment. In this connection, the number of genes thought to be involved in the different stages of different types of oral cancer increases apace. DNA microarrays allow simultaneous evaluation of the expression of hundreds of genes in a single assay. The parallel format of microassay slides is designed to allow rapid comparison of gene expression between two samples, for example tumor cells and healthy cells. This article reviews studies that have aimed to identify genes related to oral cancer, and to classify these genes into groups that are commonly co-expressed. These studies suggest that DNA microarrays are set to become routine tools in the detection, diagnosis, characterization and treatment of oral cancers.

4:	Med Oral. 2004 Aug; 9(4): 293-299
	[Orofacial pain management:An update]
	[Article in English, Spanish].
	Martorell-Calatayud L, Garcia-Mira B, Penarrocha-Diago M.
	Dr. Miguel Penarrocha Diago, Unidad Medico-Quirurgica, Clinica Odontologica, C/ Gasco Oliag, 1, 46021 Valencia E-mail: Miguel.Penarrocha@uv.es
	New treatments for orofacial pain have been developed in recent years. In the case of cluster headache, new drugs are now administered via the intranasal route, while in patients with chewing pain the topical application of capsaicin and the use of oral splints in combination with jaw movement exercises are the most widely used management approaches. In the case of neurogenic pain new anticonvulsivants have been introduced, with fewer side effects than carbamazepine. The latest pharmacological advances involve the use of nonsteroidal antiinflammatory drugs and opioids via the topical route, and the combination of different analgesics. The present review discusses the latest advances in the treatment of orofacial pain.

5:	Med Oral. 2004 Aug; 9(4): 300-303
	[Considerations on the diagnosis of oral psoriasis: A case report]
	[Article in English, Spanish].
	Migliari DA, Penha SS, Marques MM, Matthews RW.
	Dr. Dante A. Migliari, Universidad de Sao Paulo, Faculdad de Odontologia, Departamento de Estomatologia, Disc. de Semiologia, El Av. Prof. Lineu Prestes, 2227, Ciudad Universitaria, Sao Paulo, SP - Brasil 05508-900. E-mail: damiglia@usp.br
	This paper discusses the difficulties in making a definitive diagnosis of oral psoriasis based upon clinical and histological evidence only. A young black male presented with multiple lesions showing erosions, fissures, and yellowish scales on the vermilion borders of both lips. He also had erythematous-erosive areas on the gingivae, a fissured tongue showing greyish areas on its ventral surface, whitish lesions and longitudinal sulci in the hard palate with lacelike lesions on the soft palate. Biopsies from the lower lip, gingiva and soft palate showed hyperkeratosis, spongiosis, acanthosis, and elongation of rete ridges. In addition, collections intraepithelial micro-abscesses of Munro were observed. These findings are consistent with oral psoriasis. Typical cutaneous lesions and a family history of psoriasis were absent.

6:	Med Oral. 2004 Aug; 9(4): 304-308
	[Necrotizing sialometaplasia:Report of five cases]
	[Article in English, Spanish].
	Femopase FL, Hernandez SL, Gendelman H, Criscuolo MI, Lopez-De-Blanc SA.
	Dra. Silvia Lopez de Blanc, Catedra de Clinica, Estomatologica I y II B. Facultad de Odontologia, Pabellon Argentina, Ciudad Universitaria. Agencia 4, 5016. Cordoba. E-mail: silopez@odo.unc.edu.ar
	Necrotizing sialometaplasia (NS) is a self-limiting inflammatory disease, that involves salivary glands, more frequently the minor ones. Although its etiopathogenesis remains still unknown some authors suggest that a physico-chemical or biological injury on the blood vessels may produce ischemic changes, leading to infarction of the gland and its further necrosis. Its clinical and histologic feature resemble malignancy. Clinically it may appear like an ulcer with slightly elevated irregular borders and necrotic base. Histologic features are squamous metaplasia of ducts and acini and a pseudoepitheliomatous hyperplasia of the overlying mucosa. These characteristics may induce to an inapropiated diagnosis of malignant neoplasia. A correct diagnosis to avoid mutilant surgical treatments is essential, considering that it is a self-limiting disease. In this report we describe five cases of NS in females, located in minor glands of the palate.

7:	Med Oral. 2004 Aug; 9(4): 309-320
	[Evaluation of medical risk in dental practice through using the EMRRH questionnaire]
	[Article in English, Spanish].
	Chandler-Gutierrez L, Martinez-Sahuquillo A, Bullon-Fernandez P.
	Lucy J. Chandler Gutierrez, C/ Puerto de Envalira, n 4 41006 Sevilla. E-mail: lucychandler@supercable.es
	Object: Due to the fact that the population is getting older and to new medical and dental techniques, the number of medical complications during treatment is tending to increase. In order to avoid these complications a correct clinical history should be obtained of all these patients. The search for a suitable questionnaire which would be able to take into account all these factors is therefore necessary. Material and Method: In this study we have used the questionnaire EMRRH which has been proposed by a group of European investigators, in order to study the prevalence of past medical problems in a population that attends a dental clinic for treatment. Results: A total number of 716 patients were registered. Of these, 219 had a medical history that was of some interest to us. There were significant differences between the average age of the population with or without former medical problems (p<0.0005). Secondly, out of the 30.6% of the population with medical problems (N=219), we separated into groups those patients who would have a low, medium or high risk of complications when submitted to dental treatment. 17.31% of the patients were classified as risk ASA II; 9.49% as ASA III, and 2.51% as ASA IV. Among the diverse pathologies the highest percentage was hypertension (13.8%), followed by allergies to different drugs (8.37%), palpitations (7.82%), respiratory pathologies (5.16%) and diabetes (4.3%). Conclusion: We can see the obvious need for a detailed medical history to be taken because of the existing prevalence of these above pathologies taking into account that without one we could seriously harm the patient health with our dental treatment.

8:	Med Oral. 2004 Aug; 9(4): 321-327
	[Distraction osteogenesis of the alveolar ridge: a review of the literature]
	[Article in English, Spanish].
	Saulacic N, Gandara-Vila P, Somoza-Martin M, Garcia-Garcia A.
	Prof. Abel Garcia Garcia, Facultad de Odontologia, C/ Entrerrios s/n, Santiago de Compostela. E-mail: ciabelgg@usc.es
	One of the principal problems in dental implantation is the lack of sufficient bone height or width. In the case of the alveolar ridge, a very effective technique for resolving this problem is distraction osteogenesis, introduced in this context about a decade ago. This technique is based on the gradual separation of a mobile but fully vascularized bone segment from the basal bone, leading to the formation of an intervening soft callus which gradually transforms to mature bone. A key researcher in the development of this technique was the Russian traumatologist Ilizarov. The present article reviews alveolar ridge distraction procedures and their clinical application. Alveolar ridge distraction may often be preferable to bone grafting or guided bone regeneration for increasing ridge height and width prior to implantation.

9:	Med Oral. 2004 Aug; 9(4): 328-332
	[Chronic Sialadenitis revealing hepatitis C: a case report]
	[Article in English, Spanish].
	Madrid C, Courtois B, Duran D.
	Prof. Carlos Madrid, Service e Stomatologie et de Medecine Dentaire, Policlinique Medicale Universitaire, 44 rue du Bugnon, 1011 Lausanne, Tel:+41 21 314 47 66 Fax:+41 21 314 47 70. E-mail: Carlos.Madrid@hospvd.ch
	One 53-year-old male was referred with a history of sensitive peripheral neuropathy and Raynaud disease leading to suspect a Sjogren syndrome (SS). Labial salivary gland biopsy shown the classical features of chronic lymphocytic sialadenitis. As clinical and immunologic tests were positive, we conclude to a chronic lymphocytic sialadenitis simulating SS. Enzyme immunoassay and recombinant immunoblot were positive to HCV. Circulating HCV-RNA was detected by PCR. Liver biopsy revealed chronic persistent hepatitis. In one second biopsy, RNA was extracted. PCR amplification and southern blot hybridization for HCV-RNA were performed. After a 8-monthtreatment by interferon alpha, HCV-RNA was no longer detected in the serum. There was an objective improvement of the Schirmer test. The detection of HCV-RNA in the salivary glands of a Sjogren like syndrome-patient suggests that a direct infection of the salivary glands by HCV could play an important role in the pathogenesis of HCV related sialadenitis.

10:	Med Oral. 2004 Aug; 9(4): 333-339
	[Ossifying fibroma of the upper jaw: Report of a case and review of the literature]
	[Article in English, Spanish].
	Perez-Garcia S, Berini-Aytes L, Gay-Escoda C.
	Dr. Cosme Gay Escoda., Centro Medico Teknon, C/ Vilana 12, 08022 Barcelona, http//www.gayescoda.com. E-mail: cgay@bell.ub.es
	A number of processes generically referred to as benign fibroosseous lesions comprise different disorders such as fibrous dysplasia, sclerotizing osteomyelitis and ossifying or cementing fibroma. These processes are all characterized by the existence of a vascular fibroblastic stroma, with the production of a calcified matrix ranging from bone to cementum. Ossifying fibroma involves slow-evolving growth with deforming swelling generally arising in the mandible, with possible early dental displacement. From the radiological perspective the disorder generally manifests as a well defined and delimited, unilocular radiotransparency, as a radiotransparent image with central opacifications, or as multilocular transparencies. The lesions exceptionally can be radiopaque. We present the case of a 22-year-old male presenting for evaluation of a three-month, asymptomatic tumor mass in the anterior sector of the upper jaw. Radiologically, the lesion appeared as a radiotransparent zone surrounded by a poorly delimited sclerotic halo. The definitive diagnosis following surgical resection of the lesion was ossifying fibroma. The case is discussed, and a review is provided of the literature on the subject.

11:	Med Oral. 2004 Aug; 9(4): 340-344
	[Odontoameloblastoma: A case report and a review of the literature]
	[Article in English, Spanish].
	Martin-Granizo-Lopez R, Lopez-Garcia-Asenjo J, De-Pedro-Marina M, Dominguez-Cuadrado L.
	Dr. Rafael Martin-Granizo Lopez, C/ Guzman el Bueno, 70, 4 A, 28015, Madrid, Tel: 34-91-330 31 86, Fax: 34-91-447 82 23. E-mail: rmartin.hcsc@salud.madrid.org
	Odontoameloblastoma (OA) is an extremely rare mixed odontogenic tumor appearing within the maxillary bone, with both epithelial and mesenchymal components. The term odontoameloblastoma (OA) was included in the 1971 WHO classification. Only 23 well-documented cases have been reported in the medical literature. Because of their rarity, controversy exists in the treatment of this tumor. We present a new case of OA involving the mandible mimicking a compound odontoma and a brief review of the related literature.

12:	Med Oral. 2004 Aug; 9(4): 345-349
	[Hepatocellular carcinoma metastatic to the mandible: a case involving severe hemorrhage]
	[Article in English, Spanish].
	Junquera L, Rodriguez-Recio C, Torre A, Sanchez-Mayoral J, Fresno MF.
	Prof. Luis Junquera, Universidad de Oviedo. Escuela de Estomatologia, Catedratico Jose Serrano s/n. 33009. Oviedo. Spain. E-mail: Junquera@scorreo.uniovi.es
	Hepatocellular carcinoma (HCC) is quite uncommon in Europe and USA, although in this last country more than 13,000 new cases are diagnosed every year. Mandibular metastases are unusual, with only 50 cases documented. In this article, we present a 54 year-old male patient with a metastasis of HCC in right mandibular body, one year after treating the primary tumor. Curettage and biopsy of the lesion was performed, followed by a profuse hemorrhage. The patient expired six months after the biopsy, with multiple metastases. We describe the different paths for hematogenic dissemination of the process.

13:	Med Oral. 2004 Aug; 9(4): 350-354
	[Aggressive glomus tumor of the tongue: Report of a case]
	[Article in English, Spanish].
	Quesada R, Gonzalez-Lagunas J, Raspall G.
	Dr Javier Gonzalez-Lagunas, Casanova 101, Principal, 08011 Barcelona, Spain, fax 34-93 4514480, tel. 34-93 4537965.E-mail: glagunas@terra.es
	A glomus tumor or glomangioma is a benign neoplasm originating from the modified smooth muscle cells of the vascular glomus Glomangiomas of the head and/or neck are extremely rare, with an incidence of 0.6%. We present an observational case report of a recurrent glomic tumor originally located in the mobile tongue , with an aggressive clinical course that complicated the therapeutic options of the case.

14:	Med Oral. 2004 Aug; 9(4): 355-361
	[Applications of exfoliative cytology in the diagnosis of oral cancer]
	[Article in English, Spanish].
	Diniz-Freitas M, Garcia-Garcia A, Crespo-Abelleira A, Martins-Carneiro JL, Gandara-Rey JM.
	Dr. Jose Manuel Gandara Rey, Facultad de Odontologia Calle Entrerrios S/N, 15706- Santiago de Compostela - Spain, Tlfo: 981 56 31 00 Ext: 12357. E-mail: cigandar@usc.es
	Exfoliative cytology is a simple non-aggressive technique that is well accepted by the patient, and that is therefore an attractive option for the early diagnosis of oral cancer, including epithelial atypias and especially squamous cell carcinoma. However, traditional exfoliative cytology methods show low sensitivity (i.e. a high proportion of false negatives) in the diagnosis of these pathologies. This low sensitivity is attributable to various factors, including inadequate sampling, procedural errors, and the need for subjective interpretation of the findings. More recently, the continuing development of automated cytomorphometric methods, DNA content determination, tumour marker detection, and diverse molecular-level analyses has contributed to renewed interest in exfoliative cytology procedures for the diagnosis of oral cancer. The present study briefly reviews developments in these areas.

15:	Med Oral. 2004 Aug; 9(4): 362
	[Granular cell tumour]
	[Article in English, Spanish].
	Poveda R.
	Dr. Rafael Poveda, Hospital General Universitario, Servicio de Estomatologia, Avda. Tres Cruces s/n, 46014 Valencia, Spain. E-mail: Rafael.Poveda@uv.es
	[No abstract provided].