Postoperative chronic pain in arthroplasty papillon-lefèvre syndrome: 17-year dental follow-up: case report / Síndrome de papillon-lefèvre: seguimiento dental de 17 años: reporte de caso

Introduction: The present report describes the case of a 12-year-old patient with 17-year follow-up who was previously diagnosed with Papillon-Lefèvre Syndrome (PLS), which is a rare autosomal recessive irregularity in the cathepsin C gene (CTSC) characterized by palmoplantar hyperkeratosis and premature loss of primary and permanent teeth. Case Report: A specific mutation in the c.203 T > G gene inducing loss of function leading to PLS was detected, as was a mutation in the HLA-DRB1*11 allele, which is associated with this syndrome. There is no consanguinity of the parents, and the siblings are entirely healthy. Early identification of the main characteristics of this syndrome is imperative. Accurate diagnosis by genetic analysis allows differential diagnoses and timely comprehensive dental treatment. Conclusions: Additionally, it allows consultation with a dermatologist to maintain or improve the quality of life of patients with this condition due to progressive worsening and severity of the main physical manifestations. Keywords: Papillon-Lefevre Disease; Keratoderma, Palmo-plantar; Cathepsin C; Periodontitis; Skin Diseases, Genetic; Case reports

Introducción: El presente reporte describe el caso de un paciente de 12 años de edad con 17 años de seguimiento a quien previamente se le diagnosticó Síndrome de Papillon-Lefèvre (PLS), el cual es una rara irregularidad autosómica recesiva en el gen de la catepsina C (CTSC) caracterizada por hiperqueratosis palmoplantar y pérdida prematura de dientes primarios y permanentes. Reporte de Caso: Se detectó una mutación específica en el gen c.203 T > G que induce pérdida de función que conduce a PLS, así como una mutación en el alelo HLA-DRB1*11, que se asocia a este síndrome. No presenta consanguinidad de los padres, padres y hermanos totalmente sanos. La identificación temprana de las principales características de este síndrome es imperativa. El diagnóstico certero por análisis genético permite diagnósticos diferenciales y tratamientos odontológicos integrales oportunos. Conclusiones: Adicionalmente, permite la consulta con un dermatólogo para mantener o mejorar la calidad de vida de los pacientes con esta condición debido al progresivo empeoramiento y severidad de las principales manifestaciones físicas.

Incisor root length in individuals with and without anterior open bite: a comparative CBCT study

ABSTRACT Objective: This study aimed to compare the root length of maxillary and mandibular incisors between individuals with open bite versus matched individuals with adequate overbite. Methods: This comparative, matched and retrospective study included 48 cone beam computed tomographies (CBCTs) obtained at a university radiological center. Scans belonged to 24 individuals with open bite (overbite ≤ 0 mm) and 24 individuals with adequate overbite (controls). Both groups were matched by age, sex, malocclusion classification and skeletal characteristics (ANB and FMA angles). Root length of each maxillary and mandibular incisor was measured in millimeters (mm) in a sagittal section from a perpendicular line to the enamel cement junction until the root apex (384 length measurements were made). The means of root length in both groups were compared using t-tests. In addition, correlations between variables were evaluated with the Pearson correlation coefficient (α = 0.05). Results: In both groups, the root length of the upper central incisors was approximately 12 mm and the root length of the maxillary lateral incisors was approximately 13 mm (p˃ 0.05). Likewise, the root length of lower central incisors in both groups measured approximately 12 mm (p˃ 0.05). However, the mandibular lateral incisor roots of open bite patients were significantly longer than in the normal overbite patients (approximately 1 mm, p= 0.012 right side, p= 0.001 left side). Conclusions: Root length of maxillary incisors and central mandibular incisor is similar in individuals with or without open bite, but the mandibular lateral incisor roots in open bite patients were significantly longer than in the normal overbite patients.

RESUMO Objetivo: O presente estudo teve como objetivo comparar o comprimento radicular de incisivos superiores e inferiores em indivíduos com mordida aberta versus indivíduos com sobremordida normal. Método: Esse estudo comparativo e retrospectivo incluiu 48 tomografias computadorizadas de feixe cônico (TCFC) obtidas em um centro radiológico universitário. As tomografias foram realizadas em 24 indivíduos com mordida aberta (sobremordida ≤ 0 mm) e 24 indivíduos com sobremordida normal (controle). Ambos os grupos foram compatibilizados de acordo com a idade, sexo, má oclusão e padrão esquelético (ângulos ANB e FMA). O comprimento radicular de todos os incisivos superiores e inferiores foi medido em milímetros (mm) em um corte sagital, de uma linha perpendicular à junção cemento-esmalte até o ápice radicular (384 medidas de comprimento foram realizadas). A média de comprimento radicular em ambos os grupos foi comparada utilizando-se o teste t. Adicionalmente, correlações entre as variáveis foram avaliadas usando o coeficiente de correlação de Pearson (α = 0,05). Resultados: Em ambos os grupos, o comprimento radicular dos incisivos centrais superiores foi de, aproximadamente, 12 mm, e o comprimento radicular dos incisivos laterais superiores foi de, aproximadamente, 13 mm (p˃ 0,05). Da mesma forma, o comprimento radicular dos incisivos centrais inferiores, em ambos os grupos, obteve a medida de aproximadamente 12 mm (p>0,05). No entanto, o comprimento radicular dos incisivos laterais inferiores em indivíduos com mordida aberta foi significativamente maior em comparação aos pacientes com sobremordida normal (aproximadamente 1 mm, p=0,012 do lado direito, p=0,001 do lado esquerdo). Conclusões: O comprimento radicular de incisivos superiores e incisivos centrais inferiores foi similar em indivíduos com ou sem mordida aberta, mas o comprimento radicular de incisivos laterais inferiores em indivíduos com mordida aberta foi significativamente maior em comparação a pacientes com sobremordida normal.

Morphological variations of the maxillary sinus floor adjacent to periapical chronic injuries

Background: Today, there are several diagnostic methods to determine the exact size and nature of periapical lesions. Furthermore, there are studies that described thickening of the mucous membrane of the maxillary sinus (MS) in patients with periapical lesions and demonstrated a causal relation. Aims: This study aims to evaluate the morphological variations of the MS floor (MSF) adjacent to chronic periapical lesions in molars and premolars using cone-beam computed tomography (CBCT). Methods: Twenty-five CBCTs with periapical lesions adjacent to maxillary molars and premolars were evaluated. A total of 50 maxillary sinuses were analyzed (12 males and 13 women) taking into account density changes within the sinus cavity. The thickening of the sinus mucosa and the periapical lesions was measured in a caudal-cephalic direction. The axial and sagittal axis was taken as reference on the sagittal and coronal sections. Statistical Analysis: Chi-square, Fisher exact, and the Mann–Whitney tests were used in this study. Results: A significant association between the size of the periapical lesions (>4 mm) and the presence of MSF affectation was found on sagittal and coronal views (P < 0.001). No significant differences between the presence or absence of periapical lesions and the thickening of the sinus mucosa were found (P = 0.241). The presence of opacification on the MS had no direct associations with the periapical lesions. Conclusions: Maxillary sinus floor affectation was associated with chronic periapical lesions >4 mm. The opacification or thickening of the sinus mucosa was not related with the periapical lesions.

Fascitis necrotizante de origen odontogénico: revisión de literatura y reporte de caso / Necrotizing fascitis of odontogenic origin. Review of literature and case report

La fascitis necrotizante (FN) es una infección poco común. Las primeras manifestaciones clínicas incluyen fiebre, dolor intenso, edema y enrojecimiento en el sitio de la herida. Esta patología se caracteriza por la evolución fulminante y la alta tasa de mortalidad que representa. El propósito del presente trabajo es describir las características de la fascitis necrotizante de origen odontogénico mediante la presentación de un caso clìnico y una revisión de la literatura y destacar las graves consecuencias que una infección dental podría desencadenar. Se resalta el enfoque multidisciplinario en estos casos y la interacción constante entre las diferentes especialidades médico-odontológicas para garantizar una gestión adecuada de cada caso. (AU)

Necrotizing Fasciitis (FN) is a rare infection. The first clinical manifestations include fever, severe pain, edema and redness at the site of the wound. This pathology is characterized by the fulminating evolution and the high mortality rate it represents. The purpose of this work is to describe the characteristics of Necrotizing Fasciitis of Odontogenic Origin by presenting a clinical case and a review of the literature and highlight the serious consequences that a dental infection could trigger. The multidisciplinary approach is emphasized in these cases and the constant interaction between the different medical-odontological specialties to guarantee an adequate management of each case. (AU)

Tratamiento de un quiste periapical con relleno de injerto óseo mezclado con fibrina rica en plaquetas adyacente a un implante post exodoncia: Reporte de un Caso / Treatment of a apical cystic with filling bone graft mixed with fibrin rich on platelets adjacent to a post dental extraction implant: Report of a case

En este caso presentamos el tratamiento realizado en una paciente de 63 años con una lesión quística apical en el maxilar superior que involucra un incisivo lateral, diagnosticada con la ayuda imagenológica de una tomografía computarizada de haz cónico (TCHC) complementada con signos y síntomas clínicos, el procedimiento consistió en una enucleación quirúrgica dejando un defecto amplio de perdida ósea, por lo que se trató con regeneración de xenoinjerto combinada con fibrina rica en plaquetas (PRF), y adyacente se colocó implante post-exodoncia. Se hace un seguimiento de su evolución a los 8 meses con TCHC, para su valoración se evalúa los cambios imagenológica del antes y el después utilizando atenuación de rayos para determinar la densidad ósea. Como en este caso las dos tomografías fueron realizadas en distintos equipos se determinó unificar los archivos Dicom en un solo software (Dolphin Imagen 3D 11.8). El uso combinado del PRF y un xenoinjerto muestran cambios de densidad que promueve la cicatrización y aceleración de la formación de nuevo hueso, dando seguridad para la colocación de un implante circundante evaluado con TCHC. (AU)

In this case, we present the treatment performed in a 63-year-old patient with an apical cystic lesion in the maxilla involving a lateral incisor, diagnosed with the aid of a cone beam computed tomography (CBCT), supplemented with clinical signs and symptoms. The procedure consisted of a surgical enucleation leaving a wide defect of bone loss, and was treated with regeneration of xenograft combined with platelet-rich fibrin (PRF), and post-excretion implant was placed adjacent. Its evolution is monitored at 8 months with CBCT, for its evaluation is evaluated the before and after imaging changes using ray attenuation to determine bone density. As in this case the two tomographies were made in different equipment was determined to unify the Dicom files in a single software (Dolphin 3D Image 11.8). The combined use of PRF and a xenograft show changes in density that promote healing and acceleration of new bone formation, providing security for placement of a surrounding implant evaluated with CBTC. (AU)

Tratamiento de fracturas mandibulares bicondilar y parasinfisiariacon reducción abierta y cerrada: Reporte de Caso / Bicondile and parasinfissiary mandibular fractures treatment with open closed reduction: A case report

La mandíbula es el hueso más frecuentemente fracturado en la región facial. Dentro de estas, las fracturas condilares presentan una incidencia considerable pero su tratamiento sigue siendo tema de discusión, autores apoyan la reducción cerrada como tratamiento conservador, mientras que otros se inclinan por tratamientos quirúrgicos como reducción abierta. El presente reporte de caso describe las características clínicas y radiográficas de la fractura bicondilar y parasinfisiaria izquierda, y su tratamiento, en un paciente masculino de 18 años de edad, que presentó trauma maxilofacial generado por accidente en moto. (AU)