Quistes maxilares: tratamiento combinado / Jaw cysts: a combinatioin therapy

Objetivo: proteger y preservar las estructuras adyacentes en el tratamiento de quistes de gran tamaño. Caso clínico: en este artículo se compartirán dos casos clínicos de lesiones quísticas de pacientes que han concurrido al servicio de Cirugía Bucomaxilofacial del Hospital Interzonal de Agudos San Roque de Manuel B. Gonnet. Conclusión: se debe confeccionar un correcto diagnóstico y elaborar un plan de tratamiento oportuno que permita le eliminación de la lesión y la neoformación ósea.

Lingual Cortical Mandibular Bone Depression: Frequency and Clinical-Radiological Features in a Brazilian Population

The aim of this study was to report the frequency and clinical-radiological features of cases of lingual cortical mandibular bone depressions (LCMBD) diagnosed in consecutive panoramic radiographs and cone-beam computed tomography (CBCT) scans from a Brazilian population. The methods included a retrospective analysis of consecutive panoramic radiographs, charts from the Oral Medicine clinic and consecutive CBCT scans. All cases diagnosed as LCMBD were selected and clinical-radiological data were retrieved from the clinical charts and by the analysis of the image exams. Twenty LCMBD cases diagnosed in 18 patients were found, including 2 from 3,000 consecutive panoramic radiographs (0.07%), 6 from 2,421 Oral Medicine patients (0.25%) and 10 from 1,684 CBCT scans (0.59%). The 18 patients had a mean age of 51.5 years and 13 were males. Two patients presented bilateral lesions. Fourteen images (70%) were classified as well-defined. Eighteen affected the posterior area of the mandible and two affected the anterior mandible. Size of the lesions was larger in younger patients. In conclusion, there seemed to be a considerable radiological heterogeneity when comparing the LCMBD cases and it seemed that the images decreased in size with the increase of patient's age.

Resumo O objetivo deste estudo foi relatar a frequência e os achados clínico-radiográficos dos casos de depressão cortical mandibular lingual diagnosticados em radiografias panorâmicas e em tomografias computadorizadas realizadas pela técnica de feixe cônico consecutivas em uma população brasileira. A metodologia incluiu uma análise retrospectiva de radiografias panorâmicas consecutivas, dos registros dos pacientes da clínica de estomatologia e tomografias computadorizadas consecutivas realizadas pela técnica do feixe cônico. Todos os casos com diagnóstico de depressão cortical mandibular lingual foram selecionados e as informações clínico-radiográficas foram obtidas a partir dos prontuários dos pacientes e da análise dos exames imaginológicos. Um total de 20 casos de depressão cortical mandibular lingual foi diagnosticado em 18 pacientes, incluindo 2 casos em 3.000 radiografias panorâmicas (0,07%), 6 em 2.421 pacientes da clínica de Estomatologia (0,25%) e 10 em 1.684 pacientes do grupo submetido a tomografia computadorizada (0,59%). Os 18 pacientes mostraram uma média de idade de 51,5 anos e 13 eram do gênero masculino. Dois pacientes apresentaram imagens bilaterais. Quatorze imagens (70%) foram classificadas como bem definidas; dezoito acometeram a região posterior da mandíbula e dois casos acometeram a região anterior da mandíbula. O tamanho das lesões foi maior em pacientes mais jovens. Em conclusão, existe uma considerável heterogeneidade na expressão radiográfica das imagens e parece haver uma diminuição do tamanho das imagens com o aumento da idade dos pacientes. .

Reemplazo articular temporomandibular debido a queratoquiste odontogénico / Temporomandibular joint replacement because of odontogenic keratocyst

Existen disímiles condiciones que hacen necesario el reemplazo articular temporomandibular; dentro de las más frecuentes se encuentran la anquilosis, la osteoatrosis, estadíos avanzados del Síndrome de disfunción temporomandibular, daño articular postrauma y procesos neoplásicos o tumorales. Los queratoquistes odontógenos que se agrupan para su estudio dentro de los quistes odontogénicos del desarrollo, representan cerca del 7 al 10 por ciento de todos los quistes maxilo-mandibulares. Se dice que tienen dos picos de incidencia entre la segunda y tercera década de vida y entre los 50 y 60 años de edad, con una ligera predilección por el sexo masculino. Aparece más frecuentemente en la región del tercer molar de la mandíbula con extensión a la rama ascendente El presente trabajo tuvo como objetivo mostrar el caso de un paciente masculino de 57 años de edad en el que fue necesario el reemplazo articular temporomandibular debido a un queratoquiste odontogénico que involucraba la totalidad de la rama mandibular derecha, incluyendo el proceso condíleo y coronoideo, así como el ángulo hasta el tercio posterior del cuerpo mandibular. Tras un año de realizada la intervención quirúrgica la evolución del paciente fue satisfactoria(AU)

Temporomandibular joint replacement is required in a variety of conditions. Among the most frequent are ankylosis, osteoarthrosis, advanced stages of the temporomandibular dysfunction syndrome, post-traumatic joint damage, and neoplastic or tumoral processes. Odontogenic keratocysts, which are classified as developmental odontogenic cysts for study purposes, constitute 7-10 per cent of all maxillomandibular cysts. Two peaks have been identified in their incidence: between the second and third decades of life, and between 50 and 60 years of age, with a slight predominance of the male sex. They are most common in the third molar area of the mandibule, with expansion to the ascending branch. A case is presented of a male 57-year-old patient requiring temporomandibular joint replacement due to an odontogenic keratocyst involving the entire right mandibular branch, including the condylar and coronoid processes, as well as the angle as far as the posterior third of the mandibular body. One year after surgery, the patient's evolution was satisfactory(AU)

A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan

OBJECTIVE: The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan. PATIENTS AND METHODS: Approximately 10 percent of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study. RESULTS: In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5 percent) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5 percent), followed by the buccal mucosa (654, 23.4 percent) and the tongue (392, 14.2 percent). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases). CONCLUSION: As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.

Quistes de los maxilares en niños: un análisis clínico / Jaw cysts in children: a clinical analysis

Objetivo: Realizar una evaluación epidemiológica de los quistes odontogénicos en pacientes de 0 a 14 años de edad, verificando cuáles son las lesiones de mayor incidencia entre estas edades. Métodos: Fueron evaluadas 100 fichas histopatológicas de lesiones diagnosticadas como quistes de naturaleza odontogénica, enfatizando las características clínicas (género, edad, tipo de lesión quística, localización anatómica y tamaño de la lesión) y radiográficas. Resultados: Fue observado que el género masculino, con edad media de 9, 78 años, así como las regiones posterior de mandíbula y anterior de la maxila fueron más comprometidos. El quiste dentígero fue la lesión más común, seguida del quiste radicular. Se observó además, que en la muestra evaluada el aspecto radiográfico unilocular y las lesiones asintomáticas fueron las más frecuentes. Conclusiones: Se concluyó que es muy importante realizar este tipo de estudios, una vez que a través de ellos podemos conocer la frecuencia e incidencia de diversas lesiones, principalmente en pacientes pediátricos, en los cuales poco se conoce sobre la prevalencia de las lesiones quísticas de los maxilares.

Objective: To realize an epidemiologic survey of odontogenic cysts in patients from 0 to 14 years old in order to find out the most prevalent lesions of each age period. Methods: 100 histopathologic files of lesions diagnosed as cysts of odontogenic origin were retrieved emphasing their clinic (cystic lesion pattern, gender, age, anatomical site and lesion lenght) and radiographic features, which the surgical specimens were forwarded for the Oral Pathology Service of UFRN. Results: It could be identified that either the male gender, with an age average of 9,78 years, or the mandible posterior and the anterior maxilla region were more involved. Dentigerous cyst was the most prevalent lesions, followed by the radicular cyst. Moreover, a unilocular radiolucence and asymptomatic lesions were more common in the sample. Conclusions: To sum up, it can be infered the outstanding relevance of studies like the present since that it is through than that it can be reached the knowledge of the frequency and incidence of several lesions, especially in paediatric patients in as much as the few knowledge of the cystic lesion prevalence in their jaws.