Browsing by Author "Rodríguez Coyago, María de Lourdes"

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A systematic review on modulation of oral biofilm and immune response associated to mucosa with probiotic bacteria as a potential approach in the prevention of dental caries
(BP Internacional, 2021) Rodríguez Coyago, María de Lourdes; Buestan Zambrano, Juan Fernando; Yamunaque Vire, Jessica Micaela; Pinos Gavilanes, Maria Paz; Osorio Ayala, Lesly Damaris
Background: A variety of approaches have been developed for the control of dental caries, a pathology with high incidence and prevalence worldwide. The use of probiotic strains for the modulation of dental biofilm in the prevention of caries has been studied, but the available evidence shows varied methodologies; and the strains tested differ from one study to another. Objective: To analyze the efficacy of using probiotic strains to prevent caries through the modulation of biofilm and immune response associated to oral mucosa. Methods: A search was made in the scientific bases PubMed, Cochrane and Science Direct, prioritizing randomized double and triple-blind clinical trials from 2010 to 2020, including a total of 20 studies to be analyzed. The selection criteria were consistent with the Preferred Reporting Items for Systematic Reviews protocol. Results: Within the studies, different types of probiotic bacteria were analyzed, dominating Lactobacillus paracasei. While most clinical trials show a favorable response in terms of a significant reduction of Streptococcus mutans in the oral microbiota, very few studies evaluated salivary pH and sIgA levels. Conclusions: The heterogeneity of the studies analyzed and the multifactorial nature of dental caries do not allow us to ensure that probiotic therapy is completely effective in preventing this pathology. Although probiotic therapy can help by regulating the microbiological factor, there are other determinants that can favor the development of caries and that are barely approached in their relationship with bacteriotherapy. Future studies that homogeneously evaluate the use of probiotics could give us a clearer idea of their effectiveness
Ameloblastomas BRAF V600E mutantes: una revisión sistemática sobre su manejo clínico y terapéutico
(Universidad de Cuenca, 2025-09-22) Arévalo Vintimilla, Paula Daniela; Rodríguez Coyago, María de Lourdes
The evidence regarding the impact of the BRAFV600E variant on the prognosis of ameloblastoma is, at present, contradictory; Additionally, there are no clinical guidelines that compile the most significant data and direct the clinical procedure when diagnosing this tumor. Objective: To determine by systematic review the level of evidence available in terms of the diagnosis, prognosis, and treatment of BRAFV600E mutant ameloblastomas, delving into the possible benefit of molecular chemotherapy directed at the activating V600E genetic alteration in the BRAF protooncogene, without additional mutations, and in neoadjuvant scheme. Materials and methods: Based on the PRISMA guideline, a systematic bibliographic search was carried out in scientific databases of clinical studies published in the last 10 years on the prognostic diagnosis and treatment of BRAFV600E mutant ameloblastomas. Results: The diagnosis of a BRAFV600E ameloblastoma is guided by clinical-radiographic criteria, reinforced with pathological criteria, and confirmed with molecular biology aimed at determining the V600E variant, which, according to strong evidence, is related to greater disease-free survival. disease. Molecularly targeted chemotherapy, with an exclusive BRAF inhibitor, appears to offer a benefit over chemotherapy directed at two molecular targets of the MAPK pathway for recurrent or metastatic cases. Conclusion: The clinical and therapeutic management of BRAFV600E mutant ameloblastomas requires a multidisciplinary approach. Treatment with exclusive inhibitor in neoadjuvant therapy demonstrates survival advantages, and is reserved for recurrent or metastatic cases, although the evidence is deficient in quantity and quality.
Burning mouth syndrome as a manifestation of an unbalanced psycho-neuro-immuno- endocrine axis in mentally ill women with intestinal dysbiosis: A literatura review
(Universidad de Cuenca, 2022-10-19) Bolaños Castillo, Mayra Daniela; Zumba García, Erika Gabriela; Rodríguez Coyago, María de Lourdes
Background: Burning mouth syndrome is currently defined as a type of chronic orofacial pain of unknown etiology; however, several publications describe this syndrome as a neurological disorder with multifactorial pathogenesis in which psychogenic, endocrine, and neuropathic factors are involved. The objective of this article is to propose an etiopathogenic model of BMS based on clinical and preclinical evidence published to date. Methods: Through a systematic bibliographic search in 4 scientific databases: PubMed, Science Direct, Embase and the Cochrane library, of articles published in English in the last 20 years. Results: We dare to propose BMS as a trigeminal small-fiber sensory neuropathy influenced by low-grade chronic systemic inflammation, in a scenario of intestinal dysbiosis or psychiatric disorders and exacerbated in peri or postmenopausal women, due to neuroprotective steroid deficiency and greater propensity to psychological disturbances. Conclusion: It is necessary to develop lines of research linked to the taxonomic and functional characterization of the intestinal microbiome in patients with BMS and to compare it with that obtained in mentally ill patients without BMS against a control group, in order, to elucidate its pathogenesis and find new therapeutic targets that allow us to better manage the syndrome, with stable responses over time.
Colonización oral y orofaríngea por Enterobacteriaceae: una revisión narrativa sobre su epidemiología e impacto clínico
(Universidad de Cuenca, 2024-09-13) Sanmartín Zhunio, Belén Estefanía; Monge Puma, Belen Micaela; Rodríguez Coyago, María de Lourdes
The Enterobacteriaceae family encompasses a broad group of Gram-negative bacteria of the order Enterobacteriaceae, usual residents of the intestinal and urinary tracts, behaving only as allochthonous in the oral cavity. There is no consensus regarding prevalence, determinants and consequences of upper aero-digestive colonization by this family of bacteria. In view of this, a narrative review was made on the epidemiology and clinical impact of oral and oropharyngeal colonization by Enterobacteriaceae, differentiating by age groups. An organized bibliographic search was carried out in digital databases: PubMed/MEDLINE, Scielo, Google Scholar and Cochrane library of clinical and preclinical studies published in the last twenty years. Oral and oropharyngeal colonization by Enterobacteriaceae was 38.24 and 39%, respectively. The genera Enterobacter spp. (68.75%), Klebsiella spp. (68.75%), Escherichia spp. (43.75%), Citrobacter spp. (25%), Pantoea spp. (25%) were the most prevalent taxonomic groups in the oral cavity, especially in children and adolescents, while Klebsiella spp. (22.5%), Escherichia spp. (15.5%) and Enterobacter spp. (8%) were the most prevalent in the oropharyngeal area of elderly subjects. This colonization is associated with an increased risk of infectious and inflammatory episodes such as pneumonia, inflammatory bowel disease, periodontal disease, and progression of renal failure; with determinants that differ according to age, with periodontal disease being a shared risk factor for senile and nonsenile groups. The presence of enterobacteria in the upper aerodigestive tract is significant, dominating in infant-adolescents, promoted by various factors that differ according to age and with systemic consequences of an infectious or inflammatory nature in certain types of hosts.
Heterogeneidad de genotipos VPH en condiloma acuminado orofaríngeo: reporte de caso procedente de Ecuador
(Universidad de Cuenca. Facultad de Odontología, 2025-10-21) Guerrero Osorio, Rodrigo Federico; Rodríguez Coyago, María de Lourdes
Introduction: Condyloma acuminatum (CA) or venereal wart is a viral infection caused by Papillomavirus, acquired primarily through sexual contact; adolescents and young adults are the most vulnerable group to this condition. Its presentation in the oral cavity is atypical, as is its positivity for viral genotypes other than 6, 11, 16 and 18. Clinical case: We present an unusual case of oropharyngeal condyloma in a young adult woman with dyslipidemia and vitamin D deficiency, which showed co-infection with low (HPV-6 and 11) and high oncogenic risk genotypes (HPV-59 and 82). To date, these last two have not been documented in cases of oral or oropharyngeal cancer. The diagnosis of the reported lesion was based on clinical and pathological findings; its prognosis was reserved, given its location. Conclusion: Although the diagnosis of AC is fundamentally clinical, for the oral entity the histopathological findings are key when differentiating it from other oral HPV-mediated entities. Genotyping is not decisive in the diagnosis, having only an epidemiological impact when developing and applying vaccination schedules.
Lesión liquenoide oral de difícil diagnóstico en paciente ex - afecto a cocaína: a propósito de un caso
(Universidad de Cuenca, 2013-11) Rodríguez Coyago, María de Lourdes; Montalvo Jaramillo, Anhaly Carolina; Niemes Palacios, Gabriela Katiuska
Oral lichenoid lesions (OLL) are considered a variation of Oral Lichen Planus (OLP) and can be recognized as a sepárate entity in itself or as an exacerbation of existing OLP. We report a male patient, 42, smoker, with a history of brain trauma and cocaine and alcohol use for 20 years. The patient is currently in recovery and has being medicated with phenytoin and pentoxifylline for 6 years. The patient attended the Diagnostic Service of the Faculty of Dentistry at the University of Cuenca, with severe oral pain with 7 days of evolution, which prevented him from eating. Stomatological examination showed erosive lesions surrounded by white reticular plaques at the hard palage level, gums and lip mucosa with skewed distribution. The histopathological diagnosis was not defin itive, but based on history, clin ¡cal, effective response to steroid treatment, and the results of immunological tests, it was determined as idiopathic oral lichenoid lesión. Because of the aberrant histological pattern, this type of lichenoid injury would be excluded from the categories established by the WHO for oral lichenoid reactions.
Metastasizing ameloblastoma: a systematic review in search of clinicopathological predictors
(Universidad de Cuenca, 2021-07-15) Buestán Zambrano, Juan Fernando; Rodríguez Coyago, María de Lourdes
Introduction: Ameloblastoma is a benign odontogenic tumor that is aggressive and localised in nature, listed as the first or second most prevalent odontogenic tumor and rarely tends to metastasis, but when it does, it receives the definition adopted by the WHO in 2017 of metastasizing ameloblastoma. Materials and Methods: This systematic review of clinical case reports of metastasizing ameloblastoma from the last 10 years, collected from PubMed, ScienceDirect and Cochrane digital databases, aims to search for association between clinical/pathological and/or molecular parameters of ameloblastoma and its metastatic potential. Results: The targeted search yielded 14 publications with a total of 18 clinical cases, which showed a mean age for diagnosis of metastasizing ameloblastoma of 46 years, with no gender predilection and a high probability of occurrence in the yellow Asian race, favouring a pattern of distant dissemination. The highest frequency of metastasis was associated with mandibular primary lesions diagnosed in young patients, and the most frequently found variant was the multicystic solid type, follicular subtype; distant metastasis was the predominant form of presentation, with the lungs being the main target. Conclusion: At the moment, there is nothing that can predict metastatic potential in ameloblastoma. More standardised studies exploring the molecular terrain are needed, as this is a key and understudied factor.
Onco-preventive management of oral leukoplakia lesions by topical 5-ALA-mediated photodynamic therapy: A systematic review of clinical trials
(Universidad de Cuenca, 2022-09-29) Ayala Jimbo, David Israel; Cárdenas Campoverde, Juan Diego; Rodríguez Coyago, María de Lourdes
Oral leukoplakia is the most prevalent potentially malignant disorder of the oral mucosa globally and its management remains a challenge. Photodynamic therapy is a minimally invasive alternative method in the treatment of premalignant lesions; and the use of the topical 5-ALA photosensitizer plus irradiation with light emitting diode (LED) or laser light has been one of the most recommended approaches for the treatments of oral leukoplakia by photodynamic therapy. The present study was carried out to determine its clinical efficacy as a chemoprevention alternative in the different clinical forms of oral leukoplakia. An exhaustive search of scientific articles published in the last 30 years in English was carried out, using keywords with the MeSH guideline, about the use of topical 5-ALA-mediated photodynamic therapy as a photosensitizer and under low intensity laser radiation or light LED as a source of illumination, in different digital bases. The systematic review under PRISMA guidance recognized an efficacy of 88.6% for this mode of phototherapy in the management of oral leukoplakia, with a greater effect size in the homogeneous clinical forms with dysplastic changes, regardless of the type of light source. However, the evidence used in this analysis was moderate. Based on the results of the present study, we can conclude that topical 5-ALA-mediated photodynamic therapy appears to be a high-performance alternative in the oncopreventive management of oral leukoplakia lesions. However, we recommend running controlled and randomized clinical trials with homogeneous methodologies that allow us to generate a met analysis with a high level of evidence.
Oral dysbiosis exacerbates candida parapsilosis sensu stricto biofilm production via up-regulation of the CPH2 biofilm master gene
(2021) Rodríguez Coyago, María de Lourdes; Rosa, Alcira Cristina; Nastri, María Lorena; Jewtuchowicz, Virginia Marta
Introduction: Candida parapsilosis sensu stricto is the second to third most frequent cause of candidemia. Studies place this yeast as a frequent colonizer of niches of the oral cavity, predominantly in pathological conditions. We hypothesize that a buccal environment in dysbiosis enhances the virulence of C. parapsilosis sensu stricto. Objective: To evaluate the phenotype and molecular level of the production of biofilm in oral isolates of Candida parapsilosis sensu stricto and correlate the results with the clinical origin (dysbiosis versus eubiosis). Materials and Methods: The biofilm-forming ability was compared in 50 oral isolates of Candida parapsilosis sensu stricto obtained from patients with and without oral dysbiosis; by quantification of metabolic activity. The results were corroborated by confocal fluorescence microscopy, and correlated with the transcriptional activity of CPH2, by RT-qPCR. The data were analysed by Excel 2010, and InfoStat 2018, with a 95% confidence interval. Results: The metabolic activity in biofilm was significantly higher in oral dysbiosis relative to control (p = 0.0025). Basal expression of CPH2 increased 2.8 times more in oral dysbiosis related to the control condition and showed no significant differences with pathogenic isolates of this same yeast, derived from onychomycosis lesions. Conclusion: The oral cavity in dysbiosis increases the virulence of C. parapsilosis sensu stricto due to possible changes in epigenetic marks. This finding suggests that the oral cavity in dysbiosis may be an alternative route to the skin in the epidemiology of nosocomial candidemia.