Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review

Purpose: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. Methods: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. Results: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. Conclusions: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Characterization of Salivary Gland Pain: A Review of the Literature / Caracterización del Dolor de Glándulas Salivales: Revisión de la Literatura

SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.

Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.

Importancia del diagnóstico precoz en el carcinoma mucoepidermoide. Relato de caso clínico / Importance of early diagnosis in mucoepidermoid carcinoma. Case report

El carcinoma mucoepidermoide es el tumor maligno más frecuente de las glándulas salivales menores localizándose por lo general en el paladar. El objetivo del presente reporte de caso es evidenciar en la literatura científica la importancia del diagnóstico precoz de carcinomas orales, así como, el rol fundamental que cumple el odontólogo general para identificar, guiar y derivar al paciente a un especialista. Se presenta el caso clínico de un paciente de sexo masculino que acudió a la Facultad de Odontología de la Universidad Nacional de Asunción, quien fue derivado por su odontóloga tras percibir un pequeño pero perceptible cambio en la coloración normal de la mucosa y molestias ocasionales en la zona del paladar duro. Al examen intraoral se observó en el paladar duro, a la altura de los premolares en la hemiarcada izquierda, una lesión nodular ovoidea, color violáceo, de 1cm de diámetro, depresible a la palpación. Se realizó una biopsia incisional para su estudio histopatológico, reportando un carcinoma mucoepidermoide. El diagnóstico precoz de este tipo de patologías es un desafío para el odontólogo general, quien debe orientar al paciente, ante cualquier cambio de la estructura normal de la cavidad bucal, para que acuda a un especialista.

Mucoepidermoid carcinoma is the most frequent malignant tumor of the minor salivary glands, usually located in the palate. The objective of this case report is to demonstrate in the Paraguayan scientific literature the importance of early diagnosis of oral carcinomas as well as the fundamental role of the general dentist in identifying, guiding and referring the patient to the corresponding specialist. The clinical case presented is about a male patient who attended the Faculty of Dentistry of the National University of Asuncion. His dentist referred him after noticing a small but perceptible change in the normal coloration of the mucosa and occasional discomfort in the area of the hard palate. In the intraoral examination, an ovoid nodular lesion, purplish in color, 1cm in diameter, depressible on palpation, observed on the hard palate at the level of the premolars in the left hemiarch. An incisional biopsy performed for histopathological study, reporting a mucoepidermoid carcinoma. Regarding the early diagnosis of this type of pathology, the challenge for the general dentist will continues to be his continuous training in order to be able to successfully guide the patient in seeking care from the right specialist in case of any change in the oral cavity.

Biometry of the Submandibular Salivary Glands in Indian Population Using Computed Tomography : A Retrospective Study

Objectives : To study the biometric measurements of the submandibular salivary gland in the Indian population using Computed Tomography. Materials and Methods : From the available database, 300 patients who have undergone Computed Tomography without any salivary gland disease, the CT scans were retrospectively evaluated. The CT scans were obtained with TOSHIBA Activion 16 slice CT machine. The antero-posterior, transverse and cranio-caudal dimensions of bilateral submandibular salivary glands were measured in the axial, coronal and sagittal planes. Results : The mean CT measurements of the patients included was 2.0 ± 0.38 cm in Antero-posterior, 2.1 ± 0.31 cm in Transverse and 2.90 ± 0.27 cm in Cranio-caudal dimensions. The average volume of the submandibular gland was 6.68 ± 0.21 cc.

Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

NECROTIZING SIALOMETAPLASIA OF PALATE A RARE CASE REPORT

Necrotizing sialometaplasia (NS) is a rare benign reactive necrotizing in?ammatory process that affects the minor salivary gland and frequently mimics cancer on both a clinical and histopathological level. Case Study : We report the case of a 21-year-old healthy man who had throat pain and non-healing ulcer over soft palate for the past one month, with pain during swallowing.Histopathological analysis and an incisional biopsy were performed on the patient. Necrotizing sialometaplasia was the histologically determined diagnosis. Necrotizing sialometaplasia is a self-limiting disorder of salivary glands mostly affecting the hard palate.The duration of the healing process is usually related to the size of the lesion.The recurrence rate of Necrotizing Sialometaplasia is low.Even a full thickness palatal lesion heals completely within 6 months.

Update on salivary gland transplantation in severe dry eye / 中华实验眼科杂志

As a chronic eye disease caused by multiple factors, the treatment of dry eye disease (DED) should be individualized according to the cause and severity of the disease.In patients with severe DED who have lost lacrimal secretion but have not suffered severe damage to the salivary glands, autologous salivary gland transplantation may help bring hope to these patients if conventional treatments are not effective enough.According to the literature, the three major salivary glands and the minor salivary glands have been used as lacrimal gland replacements.Studies have shown that submandibular glands not only have a high gland survival rate after transplantation, but also maintain secretory activity after transplantation and therefore successfully serve as lacrimal gland replacement.During the up to 180-month follow-up period, the subjective symptoms and signs of DED such as dryness, foreign body sensation, and other objective indicators related to DED such as visual acuity and tear film break-up time are effectively improved.Among the minor salivary glands, the labial glands have been proven to maintain secretory function during the up to ten-year follow-up period after transplantation according to the literature, and have therefore become an alternative lacrimal gland replacement.This review summarized the indications, surgical techniques, efficacy evaluation, modulation of salivary flow and complications of the surgery, involving three major salivary glands, parotid, submandibular and sublingual glands, and minor salivary glands among which labial glands are most commonly used.

Research progress of tight junction protein Claudin of salivary glands / 口腔医学

@#Tight junction(TJ) is complex dynamic system involved in protein interactions in the paracellular secretory pathway, with both barrier and fence functions. Claudin family, the main section of tight junction strands, will be abnormal in expression pattern in the circumstances of radiation injuries, inflammation, Sj?gren's syndrome, diabetes and other pathological conditions in salivary glands. This change leads to abnormal structure and function of tight junctions, indirectly manifested as salivary gland dysfunction. In addition, the difference of Claudin expression in salivary gland tumors can also be used as an indicator of tumor type and prognosis. This review focuses on the progress of research on common Claudin in salivary glands, including the structure, function, expression patterns of related diseases and their applications. It is believed that the review may provide new ideas for clinical and basic research on Claudin protein-related diseases.

Sindrome de Sjögren: una revisión de la literatura

El síndrome de Sjögren es un trastorno crónico autoinmune que afecta a las glándulas secretoras, principalmente salivales y lagrimales; además, puede presentar manifestaciones sistémicas extraglandulares. El objetivo de esta revisión fue revisar la literatura sobre los aspectos generales del síndrome de Sjögren, para lo cual se realizó una búsqueda en bases de datos entre el 15 de enero y el 15 de marzo del 2020, en donde se obtuvieron 29 artículos sobre los cuales se hizo la revisión. El síndrome de Sjögren tiene una importante prevalencia entre las enfermedades autoinmunes más comunes, caracterizada por presentar xerostomía y xeroftalmia. Los criterios diagnósticos tienen alta sensibilidad y especificidad y su tratamiento es sintomático.

Sjögren's syndrome is a chronic autoimmune disorder that affects the secretory glands, mainly salivary and lacrimal glands; and also can present extraglandular systemic manifestations. The objective of this review was to check the literature about the general aspects of Sjorgen's syndrome, for which a search of the literature was carried out between January 15 to March 15, 2020, 29 articles were obtained on which did the review. Sjögren's syndrome is highly prevalent among the most common autoimmune diseases, characterized by xerostomia and xerophthalmia. The diagnostic criteria have high sensitivity and specificity, and their treatment is symptomatic.

Características Clínicas y Epidemiológicas en Pacientes Diagnosticados con Síndrome de Sjögren en un Hospital Universitario de Cuarto Nivel

El síndrome de Sjögren es la segunda enfermedad autoinmune crónica más prevalente; factores hereditarios y medioambientales interactúan provocando una "epitelitis autoinmune" que daña el tejido glandular exocrino principalmente, pero también a otros órganos; debido a esta heterogeneidad clínica, el diagnóstico y tratamiento constituyen un desafío. Estudios demuestran que afecta al 0,1-0,6 % de la población, con predilección por el sexo femenino (9:1). En Colombia existen pocos estudios epidemiológicos descriptivos y de caracterización en este síndrome. Caracterizar los parámetros clínicos y epidemiológicos de pacientes con síndrome de Sjögren. Se realizó un estudio observacional descriptivo de corte transversal, se revisaron historias clínicas de 409 pacientes con el síndrome que asistieron al Hospital Universitario San Ignacio entre 2012 y 2019. Los datos se analizaron usando estadística descriptiva. La edad promedio de diagnóstico fue 59 años, la relación mujer: hombre 9:1, (91,7 % y 8,3 % respectivamente). Hubo mayor prevalencia en pacientes de 51 a 60 años (131) seguido por los de 61-70 años (114). La manifestación clínica más común fue la xerostomía (90 %); la biopsia de glándula salival menor fue el examen complementario más solicitado (65 %). El compromiso óseo-articular, fue la enfermedad concomitante más asociada. La etiología de la enfermedad es poco conocida, sin embargo, su caracterización, así como la identificación de medios diagnósticos y terapéuticos ayuda en la comprensión de la clínica; dicha información permitirá el desarrollo de tratamientos cada vez más efectivos y específicos.

Sjögren syndrome is the second most common chronic autoimmune disease, environmental and hereditary mechanisms causes an autoimmune epithelitis that affect the exocrine glandular tissue mainly, but also other organs; because this broad spectrum of clinical characteristics, the diagnostic and treatment become a challenge. Studies has shown that 0.1-0.6 % of the population is affected, with predominance of females over males (9:1). In Colombia there are few descriptive epidemiological studies and characterization of the affected population. Clinical and epidemiological characterization of Sjögren syndrome patients. A descriptive cross-sectional observational study was conducted, 409 clinical histories of patients with the syndrome at San Ignacio University Hospital from 2012 to 2019 were analized. The data collected were subjected to a descriptive statistic. The average age of diagnosis was 59 years, the ratio female: male 9:1 (91.7 % and 8.3 % respectively), the highest frequency of the syndrome was found in the 51 to 60 years old group (131) followed by the 61 to 70 years old group (114). The most common clinical manifestation was xerostomia (90 %), minor salivary gland biopsy was the most frequent test requested (65 %). The osseoarticular involvement was the most frecuent concomitant disease. Although the etiology of Sjögren syndrome is little known, its characterization, as well as the identification of the diagnostic and therapeutic means used, is of great help in understanding the disease; this information will allow the development of increasingly effective and specific treatments. More studies are required, in different locations, which will highlight the differences between populations.

Role of FNAC in the diagnosis of salivary gland lesions - A tertiary care hospital experience

Introduction: Swelling of salivary glands, specifically parotid and submandibular gland presents as a common problem and being readily visible creates havoc among patients. In addition parotid/ submandibular swellings also remain a diagnostic challenge among clinicians. The aim of this study was to examine the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) as a tool for diagnosis of salivary gland lesions. Materials and Methods: This prospective observational study was done for 6 months from January 2022 to June 2022 at Dhiraj General Hospital, SBKSMI and RC, Waghodia, Gujarat. In present study, total 42 cases were taken with salivary gland lesions that underwent FNAC in Pathology department. Results: In the present study, we had included 42 cases of salivary gland lesions. Out of 42cases, 12 (28.5%) cases were neoplastic and 30 (71.5%) cases were non-neoplastic. Among 12 neoplastic cases, 8 (67%) cases were found out to be benign and 4(33%) cases were diagnosed as malignant. Among malignant lesions, mucoepidermoid carcinoma has the highest number of cases (50%) followed by Carcinoma-ex pleomorphic adenoma and Adenoid cystic carcinoma. Conclusion: We found a good concordance between FNAC and final histology. Awareness of the therapeutic implications and limitations of the cytological interpretation amongst both the clinicians and the cytopathologists should enable FNAC to its best advantage.

Sialoendoscopia y abordaje mixto para el manejo dela patología obstructiva de las glándulas salivales / Sialoendoscopy and mixed approach for the management of obstructive pathology of the salivary glands

Introducción. La sialoendoscopia es un procedimiento cuya finalidad es visualizar los conductos salivales. Se utiliza como método diagnóstico y terapéutico de procesos inflamatorios, estenosis de los conductos y procesos obstructivos. Métodos. Describir los procedimientos realizados para el tratamiento de pacientes con patología inflamatoria y obstructiva de las glándulas salivales, de forma única con sialoendoscopia o con abordajes mixtos. Resultados. Un total de 24 pacientes fueron incluidos en el estudio, con edad promedio de 42 años, en su mayoría mujeres y compromiso submaxilar en 58,3 % y de parótida en 41,7 %. Respecto a la intervención, al 29,2 % de los sujetos se le realizó extracción de cálculos, al 29,2 % sialoplastia, al 25 % dilatación de conductos y al 37,5 % lavado de conductos en el mismo momento quirúrgico. Conclusión. La sialoendoscopia y el abordaje mixto es un procedimiento que puede garantizar el manejo de patologías obstructivas y estenosis de los conductos salivales, con buen pronóstico y resultados, preservando la glándula y evitando las complicaciones de la cirugía.

Introduction. Sialoendoscopy is a procedure which purpose is to visualise the salivary ducts. It is used as a diagnostic and therapeutic method for inflammatory and obstructive processes and duct stenosis. Methods. To describe the procedures performed for the management of patients with inflammatory and obstructive pathology of the salivary glands, only with sialoendoscopy or with mixed approaches. Results. A total of 24 patients were included in the study, with mean age of 42 years, mostly female, and 58.3% submaxillary involvement 41.7% parotid involvement. Regarding the intervention, 29.2% of the subjects underwent stone extraction, 29.2%, sialoplasty, 25% duct dilatation, and 37.5% duct lavage at the same surgical time. Conclusions. Sialoendoscopy and the mixed approach is a procedure that can guarantee the management of obstructive pathologies and stenosis of the salivary ducts with good prognosis and results, preserving the gland and avoiding the complications of surgery.

Hallazgos histológicos de glándulas salivales mayores y menores en pacientes con enfermedad relacionada a IgG4 / Histological findings of major and minor salivary glands in patients with IgG4 related disease

Introducción: la enfermedad relacionada con IgG4 (ER-IgG4) es una afección inmunomediada, asociada con lesiones fibroinflamatorias que pueden ocurrir en casi cualquier órgano. Ante su sospecha clínica es fundamental realizar el examen histopatológico para excluir malignidad y otras enfermedades. El objetivo principal de este estudio fue describir los hallazgos histológicos de la biopsia de glándulas salivales labiales (GSL) en pacientes con diagnóstico de ER-IgG4 y, posteriormente, comparar estos hallazgos con la histología e inmunohistoquímica de la glándula salival mayor (GSM). Materiales y métodos: estudio retrospectivo, observacional y descriptivo sobre una cohorte de 40 pacientes con diagnóstico de ER-IgG4. Se incluyeron 26 pacientes con diagnóstico de ER-IgG4 que presentaron biopsias de GSL. Resultados: el 73% de la muestra tuvo un infiltrado linfoplasmocitario y el 11%, fibrosis con patrón no estoriforme. En ningún caso se halló arteritis obliterativa ni ninguna forma de flebitis. Al realizar la comparación con los hallazgos de las biopsias de GSM, no hubo significancia estadística. El 65% de los pacientes manifestó compromiso extraglandular y fueron los sistemas pancreato hepato biliar y las adenopatías los más afectados. Conclusiones: la biopsia incisional de glándula submandibular sería más útil y apropiada que la biopsia de GSL para un diagnóstico definitivo de ER-IgG4.

Introduction: IgG4-related disease (IgG4-RD) is an immune-mediated condition associated with fibroinflammatory lesions that can occur in almost any anatomical site. Histopathological examination is essential when suspected to diagnose it to exclude malignancy and other diseases. The objective of this study was to describe the histological findings of the minor salivary gland biopsy (GSL) in patients diagnosed with IgG4-RD, and subsequently to correlate these findings with the histology and immunohistochemistry of the major salivary gland (GSM). Materials and methods: retrospective, observational and descriptive study on a cohort of 40 patients diagnosed with RD-IgG4. Twenty-six patients diagnosed with IgG4-RD who presented SLG biopsies were included. Results: the 73% of the samples presented a lymphoplasmacytic infiltrate and 11% of them fibrosis with a non-storiform pattern. In no case was obliterative arteritis or any form of phlebitis found. When comparing the findings of the GSM biopsies, there was no statistical significance. Sixty-five percent of the patients presented extraglandular involvement; the pancreato-hepato-biliary system and the adenopathies were the most affected. Conclusions: incisional biopsy of the submandibular gland would be more useful and appropriate than LSG for a definitive diagnosis of IgG4-RD.

Hiperplasia Adenomatoide en Reborde Alveolar Maxilar: Una Presentación Inusual

RESUMEN: La hiperplasia adenomatoide (HA) se considera una patología no neoplásica de etiología desconocida asociada principalmente a trauma como principal factor causal, con localización frecuente en paladar duro y blando. El presente caso muestra el primer caso de HA en reborde alveolar asociado a prótesis removible mal adaptada. Hombre de 81 años con diabetes mellitus y HTA controlada presentaba un aumento de volumen nodular en reborde alveolar maxilar del color de la mucosa, de consistencia firme y márgenes definidos que medía 1,5 x 0,7 cm de diámetro, asintomático y asociada a falta de diente 1.3 protésico reportando 6 años de evolución. Se realizó biopsia excisional y estudio histopatológic o con hiperplasia de acinos glandulares. El 80 % de los casos se observa en paladar seguida de la mucosa oral, lengua y zona retromolar, pero sin reportes en encía o reborde alveolar. El factor causal mayormente asociado es el trauma crónico principalmente asociado a prótesis mal adaptadas, aunque existen estudios de un cromosoma aberrante con un rol desconocido tanto en su patogénesis como en su posible potencial maligno. En el caso actual, la lesión se asocia fuertemente a prótesis removible mal adaptada sugiriendo una lesión de aspecto reactivo. Por lo tanto, la HA se debe incluir como diagnóstico diferencial tanto a nivel palatino como en otras localizaciones incluyendo reborde alveolar. Además, se debe considerar cuando existe un factor etiológico traumático como prótesis removibles mal adaptadas, siendo necesario su confirmación mediante estudio histopatológico especialmente por su similitud con otras patologías.

ABSTRACT: Adenomatoid hyperplasia (AH) is considered a non-neoplastic pathology of unknown etiology but mainly associated with trauma as the main causal factor, with frequent localization on hard and soft palate. The present case shows the first case of AH on the alveolar ridge associated with a poorly adapted removable prosthesis. An 81-year-old man with diabetes mellitus and arterial hypertension controlled presents a nodular tumor in the maxillary alveolar ridge of the color of the mucosa, with a firm consistency and defined edges measuring 1.5 x 0.7 cm in diameter, asymptomatic and associated with a lack of a 1.3 prosthetic tooth reporting 6 years of evolution. Excisional biopsy and histopathological study were performed with glandular acini hyperplasia. The AH is observed in 80 % of cases on the palate followed by the oral mucosa, tongue and retromolar area, but without reports on the gingiva or alveolar ridge. The most associated causal factor is chronic trauma, mainly associated with poorly adapted prostheses, although there are studies of an aberrant chromosome with an unknown role both in his pathogenesis and possible malignant potential. In the current case, the lesion is strongly associated with a poorly adapted removable prosthesis, suggesting a lesion with a reactive appearance. Therefore, AH should be included as a differential diagnosis both at the palatal level and in other locations including the alveolar ridge. In addition, it should be considered when there is a traumatic etiological factor such as poorly adapted removable prostheses, It's confirmation by histopathological study being necessary, especially due to its similarity with other pathologies.

Suppurative minor salivary gland sialolithiasis

ABSTRACT Sialolithiasis is a common nonneoplastic disease of the major salivary glands that often affects the submandibular glands. Minor salivary gland involvement by sialolithiasis is uncommon, with only 273 cases reported. A long clinical history, acute symptoms, and mucopurulent discharge are unusual features of these cases. Herein, we report the case of a 63-year-old woman who complained of symptomatic nodular swelling of the buccal mucosa associated with purulent discharge for several days. The clinical history lasted 15 years, with episodes of asymptomatic non-suppurative swelling in the same area. The patient underwent surgical excision. The microscopic examination revealed chronic nonspecific sialadenitis associated with psammomatous calcifications, confirming minor salivary gland sialolithiasis. After 3 years of follow-up, the patient was free of symptoms. Patients with sialolithiasis are usually asymptomatic; however, swelling, pain, and fistula may be present in rare cases. The presence of purulent exudate should lead to the differential diagnosis of stomatitis glandularis, a rare inflammatory condition affecting the minor salivary glands. Sialolithiasis and stomatitis glandularis should be considered in the clinical differential diagnosis of symptomatic suppurative nodular swelling affecting the oral mucosa, and histopathological analysis is necessary for the diagnosis.

Are salivary flow rates associated with histopathologic aspects in patients with rheumatoid arthritis?

Abstract The aim of this retrospective cross-sectional study was to verify the association between salivary flow rates (SFR) and the histopathologic aspects of labial salivary glands (LSG) in patients with rheumatoid arthritis (RA). Patients presenting rheumatologic diseases referred for oral evaluation were included in the study if they had RA and had SFR measured and LSG biopsy performed. Patients were excluded if they had systemic conditions that affect SFR or if they were being treated for hyposalivation. Cases without enough material for histopathologic analysis were also excluded. Data were collected through questionnaires, oral examination, resting and stimulated SFR, and LSG biopsies. A histopathologic reevaluation was carried out in order to seek for additional histopathologic aspects. Fifty-one patients met the inclusion criteria. The mean age was 53.5 years (25-77), and 94.1% were women. The median resting and stimulated SFRs were 0.24 mL/min and 1.02 mL/min, respectively. The presence of lymphocytic focus and fibrosis were significantly associated with stimulated SFR, but not with resting SFR. The odds ratio of patients who had hyposalivation for presenting a positive lymphocytic focus was 7.33 (confidence interval CI: 1.53-35.23) by the stimulated technique, and 2.56 (CI: 0.57-11.40) in resting SFR. In the medical records, 14 (31.80%) patients had been diagnosed with secondary Sjögren's syndrome. In conclusion, stimulated SFR represent a good screening test to predict lymphocytic focus in LSG in patients with RA, which represents the most specific test to diagnose Sjögren's syndrome.

Revisión anatómica de la cavidad oral, glándulas salivares y esófago de dos ejemplares de pudú (Pudu puda) / Anatomical review of the oral cavity, salivary glands and esophagus of two specimens of pudú (Pudu puda)

RESUMEN: El pudú (Pudu puda), pertenece al orden Artiodactyla y a la familia Cervidae, corresponde al segundo cérvido más pequeño del mundo y es endémico de Chile y Argentina. Son herbívoros que se alimentan de hojas jóvenes y brotes de algunos árboles, arbustos, hierbas, frutos y flores. Esta especie está catalogada en estado Vulnerable, por lo que se prohíbe su caza y captura, esto debido a que su población ha disminuido sustancialmente a causa de la pérdida y fragmentación de la vegetación nativa, los incendios forestales, ataques de perros asilvestrados y caza furtiva. Existe escasa información científica anatómica de esta especie, y más aún referente a su morfología digestiva, por lo que se requieren estudios que aporten información específica de este cérvido. Se utilizaron dos cadáveres de pudú hembras adultas, los cuales fueron donados por el Servicio Agrícola y Ganadero (SAG) de Talca, Región del Maule, Chile. Dentro de los resultados, podemos indicar que la cavidad oral, glándulas salivares y esófago se asemejan a otros rumiantes domésticos, como también existen semejanzas con el venado de campo, sin embargo, existen diferencias como la forma y desarrollo de la glándula parótida; el conducto parotídeo pasa ventral al músculo masetero y se abre en una papila a nivel del tercer premolar superior; la glándula mandibular se divide en tres lobos; la glándula sublingual solo posee porción polistomática, las glándulas bucales dorsales poseen un menor tamaño que las bucales ventrales, la glándula bucal ventral es alargada y de forma compacta y se observa la presencia de una redondeada glándula bucal intermedia, poseen 11 crestas palatinas por lado en el paladar duro y además la papila incisiva se encuentra rodeando al pulvino dental. Esta información es relevante y corresponde a un aporte al conocimiento específico de esta especie, la cual es endémica, vulnerable y protegida.

SUMMARY: The pudu (Pudu puda), belongs to the Artiodactyla order and the Cervidae family, corresponding to the second smallest deer in the world and is endemic to Chile and Argentina. They are herbivores that feed on young leaves and shoots of certain trees, shrubs, herbs, fruits, and flowers. The status of is species is classified as Vulnerable; therefore, its hunting and capture is prohibited, this because its population has decreased substantially due to the loss and fragmentation of native vegetation, forest fires, attacks by feral dogs and poaching. There is little scientific anatomical information available on this species, and even more so regarding its digestive morphology, which is why studies are required to provide specific information on this deer. Two adult female pudu specimens were used, which were donated by the Agricultural and Livestock Service (SAG) of Talca, Maule Region, Chile. Among the results, we can indicate that the oral cavity, salivary glands and esophagus resemble other domestic ruminants; there are also similarities with the field deer, however, there are differences such as the shape and development of the parotid gland; the parotid duct passes ventral to the masseter muscle and opens into a papilla at the level of the upper third premolar; the mandibular gland is divided into three wolves; the sublingual gland only has a polystomatic portion, the dorsal buccal glands are smaller than the ventral buccal glands, the ventral buccal gland is elongated and compact and the presence of a rounded intermediate buccal gland is observed, it has 11 palatal ridges per side in the hard palate and also the incisive papilla is found surrounding the dental pulvino. This information is relevant and corresponds to a report on the specific knowledge of this species, which is endemic, vulnerable, and protected.

Efecto de la hipoxia sobre los tejidos de la cavidad oral: revisión de la literatura / Effect of hypoxia on oral tissues: a review of the literature

La exposición a hipoxia es considerada un estímulo estresante, por lo que el organismo desarrolla meca-nismos de aclimatación para asegurar la homeosta-sis. Si bien el efecto de la hipoxia sobre los distintos sistemas de tejidos y órganos ha sido bien documen-tado, el rol de los bajos niveles de O2 en la cavidad oral no ha recibido el mismo análisis. En este trabajo se revisaron los datos bibliográficos disponibles sobre el efecto de la hipoxia sobre el tejido periodontal, las glándulas salivales, la pulpa dental y el hueso mandi-bular y alveolar. De lo analizado en la bibliografía, re-sulta evidente que los bajos niveles de O2 aumentan el número de mediadores inflamatorios que inducen la progresión de la enfermedad periodontal y, a su vez, la inflamación establecida durante dicha enfermedad agrava aún más las condiciones de hipoxia tisular. Las glándulas salivales también se encuentran afectadas durante la exposición a hipoxia, disminuyendo la can-tidad de saliva secretada, observándose alteraciones ultraestructurales en el parénquima glandular. Por otra parte, se ha establecido que la hipoxia puede te-ner efectos deseados para el cultivo de células madre de la pulpa dental, lo cual resulta útil en el campo de la odontología reparativa y también para el movimien-to dental durante los tratamientos ortodónticos. En conclusión, para determinar los efectos de la hipoxia en la cavidad oral se debe analizar no sólo el tipo de tejido involucrado sino también las condiciones de hi-poxia a las cuales éste es sometido, así también como la duración de la exposición y la modalidad de hipoxia (AU)

Exposure to hypoxia is considered a stressful stimulus, therefore the organism develops acclimation mechanisms to try to ensure homeostasis. Although the effect of hypoxia on different tissues and organs has been very well documented, the role of low levels of O2 in the oral cavity has not received the same analysis. In this review, we analyzed the available bibliographic data concerning the effects of hypoxia on periodontal tissue, salivary glands, and dental pulp. The published evidence demonstrates that low O2 levels increase the number of inflammatory mediators that induce the progression of periodontal disease, and, in turn, the inflammation established during the progression of periodontitis aggravates tissue hypoxia conditions. Salivary glands are also affected during hypoxic exposure, decreasing salivary secretion, and leading to ultrastructural alterations in the glandular parenchyma. On the other hand, hypoxia could also be beneficial in some scenarios. It has been established that dental pulp cells grow better in culture under hypoxic conditions than they do in normoxia. Furthermore, mild hypoxia seems to stimulate periodontal ligament cells proliferation and matrix degradation, key events during for orthodontic treatments. In conclusion, to determine the effects of hypoxia in the oral cavity, it is necessary to analyze not only the type of tissue involved but also the hypoxic conditions to which it is subjected, as well as its duration and modality (AU)

Antioxidant effect of chamomile tea on the salivary glands of streptozotocin-induced diabetic rats

Abstract: This study aimed to analyze oxidative stress and the activity of antioxidant enzymes in the salivary glands of streptozotocin (STZ)-induced diabetic rats with ad libitum consumption of chamomile tea in substitution of water for 21 days. Rats were divided in two control groups (untreated control and treated control) and two diabetic groups (untreated diabetic and treated diabetic). Superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) activities, total antioxidant status (TAS), and malondialdehyde (MDA) concentrations were determined. The chemical composition of the chamomile essential oil revealed 39 compounds, accounting for 93.5% of the total oils. The polyphenolic profile of the tea showed the presence of apigenin, luteolin, umbelliferone, and esculetin. SOD, GPx, CAT, and TAS levels were lower in the parotid (PA) diabetic glands, but treatment increased their concentration in both the submandibular (SM) and PA diabetic salivary glands. Increased MDA levels were observed in the PA diabetic glands, which were decreased by the consumption of chamomile tea with a reduction in hyperglycemia compared to that in untreated diabetic rats. However, the SM diabetic glands showed no difference in the MDA content. The consumption of chamomile tea prevented oxidative stress in the PA glands of diabetic rats, exhibiting hypoglycemic and antioxidant effects. Thus, chamomile tea could be a potential candidate for preventing oral complications in diabetes mellitus.

Mammary analogue secretory carcinoma in minor salivary gland

ABSTRACT Mammary analogue secretory carcinoma is a rare neoplasm usually confused with other neoplasms in the salivary glands region. It has great similarity with the breast carcinoma. We report a case of a patient who presented with gingival submucosal bleeding and lesion, with the initial histopathological examination revealing salivary gland neoplasm of low crane. Computed tomography revealed the lesion near the tooth 27, with extension to the floor of the left maxillary sinus and to the palate mucosa. Resection of the infra-structure was performed, with a diagnosis of breast cancer secretory carcinoma in the minor salivary gland.