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OBJECTIVES: To determine the prevalence and oral characteristics of cancer patients treated with bisphosphonates in the oncology and maxillofacial prosthesis departments of the General Hospital of Mexico between 2011 and 2013. MATERIALS AND METHODS: This cross-sectional study included patients who received prior treatment with bisphosphonates; an intraoral examination was performed by 2 standardized examiners. RESULTS: The prevalence of bisphosphonate-related necrosis in 75 patients was 2.6%; the most common malignancy was breast cancer (84.0%), followed by prostate cancer (16.0%). Exostosis was present in 9.3% of patients and the mean Decayed, Missing, Filled Teeth index was 4.64; 44.0% of the study group had a Community Periodontal Index value between 2 and 2.9 (mean, 0.60). CONCLUSION: A detailed intraoral assessment must be performed before initiating treatment with bisphosphonates to identify risk factors for osteonecrosis.

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OBJECTIVES: To determine the prevalence and oral characteristics of cancer patients treated with bisphosphonates in the oncology and maxillofacial prosthesis departments of the General Hospital of Mexico between 2011 and 2013. MATERIALS AND METHODS: This cross-sectional study included patients who received prior treatment with bisphosphonates; an intraoral examination was performed by 2 standardized examiners. RESULTS: The prevalence of bisphosphonate-related necrosis in 75 patients was 2.6%; the most common malignancy was breast cancer (84.0%), followed by prostate cancer (16.0%). Exostosis was present in 9.3% of patients and the mean Decayed, Missing, Filled Teeth index was 4.64; 44.0% of the study group had a Community Periodontal Index value between 2 and 2.9 (mean, 0.60). CONCLUSION: A detailed intraoral assessment must be performed before initiating treatment with bisphosphonates to identify risk factors for osteonecrosis.

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La mucositis es la reacción secundaria a la quimioterapia y/o radioterapia, existen múltiples opciones terapéuticas para tratar esta complicación, no se cuenta con un tratamiento definido por lo que el objetivo de esta revisión es el de agrupar las distintas maneras de abordar la mucositis oral y su efecto así como compartir la experiencia que se tiene en el Hospital General de México. Dentro de los tratamientos más utilizados se encuentra el empleo de fármacos protectores de mucosa, crioterapia, factores de crecimiento entre otros, el efecto deseado es retrasar la aparición de la lesión así como disminuir la severidad de las mismas, no todas las opciones se encuentran disponibles para el personal médico por lo que se deben de conocer las distintas opciones terapéuticas y la solidez científica con la que cuentan.

Mucositis is the secondary reaction to chemotherapy and / or radiotherapy, there are multiple therapeutic alternatives to treat this complication, there doesn't exist a specific therapy so the aim of this review is to coordinate the various ways of treating oral mucositis and its effect and to share the experience at the General Hospital of Mexico. Within the most widely used treatments is the use of mucosal protective drugs, cryotherapy, growth factors, among others, the main effect is to delay the onset of injury and decrease the severity of them, not all options are available for medical staff so they must know the different Iptherapeutic alternatives and the scientific soundness for each option.

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El objetivo principal de este estudio fue determinar el tipo de lesiones bucales más frecuentes en las pacientes con cáncer de mama tratadas con quimioterapia en el Hospital General de México, y establecer en qué condiciones se presentan dichas manifestaciones. Se realizó una revisión de expedientes entre los años de 1994 y 1999, estableciendo los criterios de inclusión y exclusión. De un total de 405 que fueron considerados, se incluyeron en la muestra 327 expedientes. De ellos, la incidencia de estomatotoxicidad se presentó en 122 casos, 89 de los cuales presentaron una sola manifestación bucal, 19 presentaron dos, y 14 pacientes reportaron más de dos. La relación entre la estirpe histológica del tumor se refleja presentándose en el canalicular infiltrante, lobular y otros (p < .005). Los esquemas de tratamiento con quimioterapia fueron integrados con: 5-fluoracilo, adriamicina, ciclofosfamida y metotrexato (p < .005). La dosis y estomatotoxicidad se relacionaron con p < .005.

The principal aim of the present study was to determine the type of oral lesions most frequently found in breast cancer patients treated with chemotherapy at the General Hospital in Mexico City and establish under which circumstances these manifestations occur. A file review was undertaken, spanning from 1994 to 1999. Inclusion and exclusion criteria were established. Out of 405 cases under consideration, 327 cases were included in the sample. In these selected cases, stomatotoxicity was present in 129 cases: 89 cases exhibited only a single oral manifestation, 19 cases showed two and 14 cases exhibited more than two (three or more). Relationship between histological lineage was reflected; it was present in the infiltrating ducts, lobular and others (p < .005). Treatment schemes with chemotherapy were integrated with 5-fluorouracil, adriamycin, cyclophosphamide and methrotrexate (p < .005) dosage and stomatotoxicity were related (p < .005).

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OBJECTIVE: To compare the fatty acid phospholipid composition of the umbilical artery and the placenta in cases of fetal growth retardation (FGR) and of normal growth, as well as in symmetric and asymmetric FGR. DESIGN: Case-control study. SETTING: University hospital. POPULATION: Thirty-nine FGR cases (12 asymmetric, 27 symmetric) and 78 cases with normal growth. MAIN OUTCOME MEASURES: Thin layer gas-liquid capillary chromatography of phospholipid fatty acids in umbilical artery and placental cotyledons. Newborns were classified as FGR if their weight was under the 10th percentile for our center. FGR was defined as symmetric if the ponderal index was >2.32, and as asymmetric if it was <2.32. RESULTS: In FGR, arachidonic acid was significantly increased both in placenta (24.05%+/-2.78 vs 22.46%+/-2.93) and in umbilical artery (16.76%+/-2.40 vs 15.58%+/-3.67). Indeed this increase was significantly higher in asymmetric than in symmetric FGR (25.70+/-2.32 vs 23.32+/-2.68 in placenta and 18.06+/-1.46 vs 16.14 +/-2.53 in umbilical artery). On the other hand, in the placenta there were a number of differences in the metabolic ratios analyzed when comparing symmetric and asymmetric FGR, indicating a lower DHA availability and a higher n-6 fatty acid elongation and desaturation in asymmetric FGR. CONCLUSION: FGR is characterized by an increase in arachidonic acid both in the placenta and umbilical artery phospolipids, probably reflecting a different mobilization from tissue stores. It is speculated that the different arterial composition could be partially responsible for the increased cardiovascular risk of FGR in adulthood. On the other hand the metabolic status of the placenta concerning polyunsaturated fatty acids was very different in symmetric and asymmetric FGR, suggesting a different pathogenesis.

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El defecto mas frecuente en la cavidad oral posterior a la cirugía ocurre en el maxilar. La rehabilitación del paciente depende básicamente de una prótesis conocida como obturador. Presentamos la experiencia de la Unidad de Bucodentomaxilofacial y del Servicio de Oncología del Hospital General de México, durante 1980 y 1991, con diferentes prótesis bucodentomaxilares. De 558 expedientes clínicos se seleccionó la información que permitió definir las indicaciones de las prótesis en pacientes con neoplasias malignas, especialmente en el maxilar

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The most frequent options currently available for rehabilitation of patients requiring mandibular resection, are discussed. Accordingly, prostheses are designed depending on the surgical technique employed. The most common characteristics of the oral cavity are reviewed, as well as their involvement in mandibulectomized patients. Finally, the relationship that should exist between maxillofacial prostheses and the stomatological cares required by patients who are candidates for radio and/or chemotherapy is stressed.

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