Solitary fibrous tumor: Two cases report with a focus on the differential diagnosis / Tumor Fibroso Solitário: Relato de dois casos com foco no diagnóstico diferencial

Solitary fibrous tumor (SFT) is a neoplasm of fibroblastic/myofibroblastic origin with intermediate biological behavior. We report here two cases of SFT affecting an unusual anatomical site in 58-year-old and 40-year-old female patients and discuss the differential diagnosis of this lesion. In case 01, the lesion showed the clinical appearance of an asymptomatic "blister" with normal color, rubbery consistency, measuring 0.3 cm, and affected the lower lip; while in case 02, a symptomatic red nodular lesion with a soft consistency and measuring 0.5 cm affected the floor of the mouth. Excisional biopsies were performed. Microscopically, two well-delimited benign neoplasms were observed, exhibiting the proliferation of ovoid to spindle-shaped mesenchymal cells, vascular spaces with staghorn arrangement, and the absence of mitosis figures. Immunohistochemistry was performed in case 01 to assist in the diagnosis. Weak and diffuse immunostaining was observed for α-SMA and intense and diffuse immunopositivity for Bcl-2 and CD34. Based on histopathological and immunohistochemical features, a diagnosis of SFT was rendered in both cases. The low occurrence and nonspecific clinical features of oral SFT may make its clinical diagnosis difficult. Also, morphological and immunohistochemical are essential for differential diagnosis with other mesenchymal neoplasms.(AU)

O tumor fibroso solitário (TFS) é uma neoplasia de origem fibroblástica/miofibroblastica com comportamento biológico intermediário. Nesse artigo relatamos dois casos de TFS afetando sítios anatômicos incomuns em pacientes do sexo feminino de 58 anos e 40 anos e discutir os seus diagnósticos. No caso 01 clinicamente a lesão apresentou um aspecto de "bolha" assintomática, coloração normal da mucosa, consistência borrachoide medindo 0,3 cm, em região de lábio inferior, enquanto que no caso 02, como uma lesão sintomática, vermelha, nodular com consistência mole e medindo 0,5 cm afetando o assoalho bucal. As biópsias excecionais foram realizadas. Microscopicamente, observamos duas lesões neoplásicas bem delimitadas exibindo uma proliferação de células mesenquimais variando de ovoides a fusiformes, vasos sanguíneos em formato de "chifre de veado", com ausência de figuras de mitoses. No caso 01 foi realizado análise imuno-histoquímica para auxiliar no diagnóstico. Foi observado uma marcação fraca e difusa de α-SMA e uma intensa e difusa imunopositividade para o Bcl-2 e CD34.Baseado nos achados histopatológicos e imuno-histoquímicos o diagnóstico de TFS foi estabelecido em ambos os casos. A baixa ocorrência e os achados clínicos inespecíficos do TFS oral podem dificultar o diagnóstico clínico. Além disso, as análises morfológicas e imuno-histoquimicas são essenciais para realização do diagnóstico diferencial com outras neoplasias mesenquimais.(AU)_

Effectiveness of lip repositioning in the treatment of excessive gingival display: systematic review and meta-analysis / Eficacia del reposicionamiento de labios en el tratamiento de la exposición gingival excesiva: revisión sistemática y metanálisis

Background: The objective of this systematic review and meta-analysis was to answer the questions ''Does lip repositioning surgery reduce the amount of gingiva exposed in the smile in individuals with excessive gingival display EGD (excessive gingival display)?'' and ''Is the reduction of the amount of gingiva exposed when smiling obtained with lip repositioning surgery stable over time?'' to evaluate the effectiveness of lip repositioning surgery for correcting EGD on smiling. Materials and Methods: A systematic structured search was carried out in five databases without data restriction. Studies reporting the degree of reduction in gingival ex-posure after lip repositioning surgery were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate Results: One hundred sixty-four references were retrieved and eleven studies met the eligibility criteria. Meta-analysis demonstrated that lip repositioning surgery results in a significant reduction in the amount of exposed gingival tissue (mean difference = -3.03; confidence interval = -3.55; -2.52). In addition, the results remained stable in the evaluated follow-up periods (1, 3, 6 and 12 months). Included studies had a low risk of bias. Conclusions: Lip repositioning surgery is effective for the treatment of EGD on smiling and exhibits stable results in the evaluated periods. The study was registered (CRD42020184866) in the international prospective register of systematic reviews (PROSPERO)

Antecedentes: el objetivo de esta revisión sistemática y metanálisis fue responder a las preguntas "¿La cirugía de reposicionamiento de labios reduce la cantidad de encía expuesta en la sonrisa en personas con exposición gingival excesiva (EGE)?" y "¿La reducción de la cantidad de encía expuesto al sonreír obtenido con cirugía de reposicionamiento de labios estable en el tiempo?" para evaluar la efectividad de la cirugía de reposicionamiento de labios para corregir la EGE al sonreír. Materiales y Métodos: Se realizó una búsqueda sistemática estructurada en cinco bases de datos sin restricción de datos. Se incluyeron los estudios que informaron el grado de reducción de la exposición gingival después de la cirugía de reposición de labios. La selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo se realizaron por duplicado. Resultados: Se recuperaron ciento sesenta y cuatro referencias y once estudios cumplieron con los criterios de elegibilidad. El metanálisis demostró que la cirugía de reposicionamiento de labios da como resultado una reducción significativa en la cantidad de tejido gingival expuesto (diferencia de medias = -3,03; intervalo de confianza = -3,55; -2,52). Además, los resultados se mantuvieron estables en los periodos de seguimiento evaluados (1, 3, 6 y 12 meses). Los estudios incluidos tenían un bajo riesgo de sesgo. Conclusión: La cirugía de reposicionamiento de labios es efectiva para el tratamiento de la EGE al sonreír y presenta resultados estables en los períodos evaluados. El estudio fue registrado (CRD42020184866) en el registro prospectivo internacional de revisiones sistemáticas (PROSPERO).

Electromyographic signals and the starting threshold voltage of orbicularis oris muscle in healthy rhesus monkeys / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the characteristics of electromyography (EMG) signals and the starting threshold voltages of the orbicularis oris muscles (OOM) in healthy rhesus monkeys under different muscle movement conditions. Methods: The EMG signals and the starting threshold voltages at different time points in 4 healthy rhesus monkeys were acquired and recorded with EMG device and evoked potentiometer. The voltage amplitude variation of EMG signals was analyzed, and the voltage amplitude range of EMG signals at the beginning of OOM contraction was established. The data were statistically analyzed by one-way ANOVA. Results: The EMG of OOM in healthy monkeys in the quiet, natural and continuous mouth-closed state was linear and relatively stable, and the absolute value fluctuated between 15 and 50 μV. The EMG waveform increased rapidly during the natural lip contraction movement, and its amplitude fluctuated greatly, with the highest absolute value of the peak value reaching hundreds of microvolts. The amplitude of EMG induced by continuous mouth closure was more than thousands of microvolts. There was no significant difference in EMG amplitudes of OOM in the healthy rhesus monkey under quiet and continuous lip closure at different time points (P>0.05). There was no significant difference in threshold voltages in the state of natural lip contraction of bilateral OOM at different time points (average range: 57.17-57.47 μV) in the healthy rhesus monkeys (P>0.05). There was no significant difference in threshold voltages of OOM induced by bilateral OOM at different time points(average range: 55.38-55.99 μV) in the healthy rhesus monkeys(P>0.05). There were significant differences in the absolute values of EMG amplitudes of OOM between the three lip movement modes: (30.67±8.72) μV in quiet and natural continuous lip closure (475.12±54.72) μV in natural lip contraction, and (921.22±312.79) μV in the induced persistent lip closure, with t values of -8.48, -9.35 and -5.01 respectively, all P<0.001. Conclusions: The EMG signals of OOM show different characteristics under different muscle movement conditions, which can be used as a basis for computer to judge and recognize the movement conditions of OOM. The upper limits of the EMG threshold voltage values of OOM under different motion states are 55-60 μV.

Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation / 国际口腔科学杂志·英文版

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.

Study on the effect of chin morphology on orthodontic treatment / 华西口腔医学杂志

OBJECTIVES@#To investigate the effect of different soft-tissue morphologies on the treatment of skeletal class Ⅰ malocclusion patients by analyzing measurement data before and after treatment.@*METHODS@#Pre- and post-treatment lateral cephalograms of 55 adult female Angle class Ⅰ patients were collected in the Department of Orthodontics, Hospital of Stomatology, Jilin University from January 2012 to December 2020. Chin soft-tissue morphologies in the lateral cranial radiographs were used to divide the patients into an abnormal chin morphology group (flat and retracted chins, n=27) and a normal chin morphology group (rounded and prominent chins, n=28). Relevant soft- and hard-tissue indexes were selected to study in-group varieties and intergroup differences in the varying chin morphologies before and after treatment.@*RESULTS@#The chin-lip angle, mandibular chin angle, mandibular chin vertex angle, PP-MP, LL-E, UL-E, Po-Pos, and B-B' thickness in the abnormal chin morphology group were significantly higher than those in the normal chin morphology group (P<0.05). Furthermore, m∶BMe and n∶B'Mes in the abnormal chin morphology group were signi-ficantly lower than those in the normal chin morphology group (P<0.05). After treatment, the mandibular chin angle, mandibular chin vertex angle, U1-SN, L1-MP, LL-E, UL-E, SNA, SNB, and B-B' thickness of the abnormal chin morphology group significantly decreased (P<0.05), whereas the nasolabial angle, m∶BMe, n∶B' Mes, and Po-Pos significantly increased (P<0.05). In the normal chin morphology group, the U1-SN, L1-MP, LL-E, UL-E, and B-B' thicknesses decreased significantly (P<0.05), whereas the nasolabial angle significantly increased (P<0.05). Among them, m∶BMe and n∶B' Mes were positively correlated.@*CONCLUSIONS@#Chin morphology affects the formulation of treatment plans. Compared with the normal chin morphology group, the abnormal chin morphology group required a larger retraction of incisors. Although the chin of soft-tissue morphology is related to the morphology of bones, the changes in soft tissue chin after treatment cannot be directly predicted according to the bone changes. Soft-tissue chin morphology affects the aesthetic assessment of the soft-tissue lateral profile and the change in soft tissue before and after treatment. The method of predicting the change in soft-tissue chin after treatment should consider the morphology of the soft-tissue chin.

Clinical and imaging features of eight cases of Ewing sarcoma of the jaw / 华西口腔医学杂志

OBJECTIVES@#This study investigate the clinical and imaging features of Ewing sarcoma (ES) of the jaw.@*METHODS@#Eight cases of pathologically diagnosed ES of the jaw from January 2010 to June 2022 were included in the study. Clinical and radiological features were retrospectively analyzed.@*RESULTS@#Among the eight cases, the mean age at onset was 29.4 years, and the male to female ratio was 7∶1. The predilecting site was the posterior part of mandible, accounting for 75% of the cases. The lesions often exhibited early numbness of the lower lip and lymphadenopathy. The main radiographic manifestation of mandibular lesions was ill-defined radiolucency, mixed with fibrous or brush-like tumor matrix, and soft tissue mass. The maxillary ES lesions mainly presented as lytic bone destruction accompanied by adjacent soft tissue mass. Periosteal ossification was rarely seen.@*CONCLUSIONS@#The clinical and imaging characteristics of ES in the jaw are helpful for its diagnosis.

Prevalence and factors associated with gummy smile in adolescents: a cross-sectional analysis

Aim: To evaluate the prevalence and factors associated with gummy smiles in adolescents aged between 15 and 18 years attending high school. Methods: The cross-sectional and quantitative study was carried out during the Covid-19 pandemic, with 160 adolescents, from two public (A1) and two private (A2) schools chosen by lottery, divided into two groups: G1 (with gummy smile) and G2 (no gummy smile). A clinical examination was carried out on the adolescents, investigating the presence or absence of a gummy smile (GS), by analyzing the variables (interlabial distance at rest, upper incisor exposure at rest, smile arc, measurement from the subnasal to the upper lip philtrum, upper lip length, upper lip thickness, hypermobility and lower/middle third ratio). Means and dispersion were obtained, and the Chi-square association test was applied, to compare the results between A1 and A2 and between G1 and G2. Results: The prevalence of GS was 33.8% (=54). It was found that no statistically significant associations were found (p > 0.05), regarding the type of school and gender with the presence of GS in adolescents. There was no statistically significant difference (χ² = 1.82; p = 0.07) between the groups and the age of adolescents. There was a significant association between the studied variables and GS (p < 0.05). Conclusion: The prevalence was high with a predominance of females. There were no statistically significant associations regarding the type of school and gender, but there was a significant association between gummy smile and lip dimensions

Ictiosis arlequín en un neonato / Arlekin ichthyosis in a newborn baby

Se describe el caso clínico de un neonato, producto de parto eutócico, a término y normopeso, asistido en el Hospital Distrital de Barrillas, perteneciente a la zona rural del Departamento Huehuetenango en Guatemala, que al nacer presentó escamas grandes y gruesas diseminadas en la piel, así como eversión de párpados y labios. Se le diagnosticó ictiosis arlequín, por lo que se mantuvo ingresado en la Unidad de Cuidados Neonatales de dicho centro. La evolución fue desfavorable, con persistencia de complicaciones, tales como sepsis grave y alteraciones hidroelectrolíticas, a pesar del tratamiento médico, por lo que falleció a los 6 días de nacido e igual período de hospitalización.

The case report of a newborn baby, product of an eutocic childbirth, at term and normal weight, is described. He was assisted in Barrillas Distrital Hospital, belonging to the rural area of the Huehuetenango Department in Guatemala due to big and thick flakes disseminated in the skin when being born, as well as eversion of eyelids and lips. Arlekin ichthyosis was diagnosed, reason why he was admitted to the Neonates Care Unit of this center. The clinical course was unfavorable, with persistence of complications, such as serious sepsis and hydroelectrolitic disorders, in spite of the medical treatment, reason why he died after 6 days of being born and same period of hospitalization.

Preliminary clinical application verification of complete digital workflow of design lips symmetry reference plane based on posed smile / 北京大学学报(医学版)

OBJECTIVE@#To automatically construct lips symmetry reference plane (SRP) based on posed smile, and to evaluate its advantages over conventional digital aesthetic design.@*METHODS@#Eighteen subjects' three-dimensional facial and dentition data were gathered in this study. The lips SRP of experimental groups were used with the standard weighted Procrustes analysis (WPA) algorithm and iterative closest point (ICP), respectively. A reference plane defined by experts based on regional ICP algorithm, served as the truth plane. The angle error values between the lips SRP of WPA algorithm in the experimental groups and the truth plane were evaluated in this study, and the lips SRP of ICP algorithm of the experimental groups was calculated in the same way. The lips SRP based on posed smile as a reference for aesthetic design and evaluate preliminary clinical application.@*RESULTS@#The average angle error between the lips SRP of WPA algorithm and the truth plane was 1.78°±1.24°, which was smaller than that between the lips SRP of ICP and the truth plane 7.41°±4.31°. There were significant differences in the angle errors among the groups (P < 0.05). In the aesthetic design of anterior teeth, automatically constructing the lips SRP of WPA algorithm based on posed smile and the original symmetry plane by re-ference compared with the prosthetic design, the subjects' scores on the lips SRP of WPA algorithm based on posed smile (8.48±0.57) were higher than those on the original symmetry plane (5.20±1.31).@*CONCLUSION@#Automatically constructing the lips SRP of WPA algorithm based on posed smile was more accurate than ICP algorithm, which was consistent with the truth plane. Moreover, it can provide an important reference for oral aesthetic diagnosis and aesthetic analysis of the restoration effect. In the aesthetic design of anterior teeth, automatically constructing the lips SRP of WPA algorithm based on posed smile can improve the patients' satisfaction in esthetic rehabilitation.

Spicy food consumption and risk of lip, oral cavity and pharynx cancers: a prospective cohort study of Chinese adults / 中华流行病学杂志

Objective: To explore the association of spicy food consumption and risk of lip, oral cavity, and pharynx cancers (LOCPs) in Chinese adults. Methods: Based on the baseline survey and long-term follow-up of the China Kadoorie Biobank (CKB) study, Cox proportional hazard regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for associations between spicy food consumption and LOCPs incidence. Results: Of the 510 145 participants included at baseline, 30.1% reported daily spicy food consumption. During a mean follow-up of 10.8 (2.0) years, we documented 767 LOCPs cases. Multivariate adjusted analyses showed that the risk of LOCPs incidence decreased with the frequency of spicy food intake (trend P=0.003), with HR of 0.69 (95%CI:0.54-0.88) for daily spicy food consumers, compared with never or occasional consumers. Participants who preferred moderate pungency degrees had the lowest risk of LOCPs, with a 33%[0.67(95%CI:0.52-0.87)] reduced risk compared to those who consumed spicy food less than once per week. The later the starting age, the lower the risk (trend P=0.004). Those who started eating spicy food after 18 years old had the lowest risk of LOCPs incidence, with adjusted HR (95%CI) of 0.70(0.54-0.92). Conclusions: Spicy food intake might be associated with a decreased risk of LOCPs incidence. Such association was independent of healthy lifestyles. Advocating moderate-pungency spicy food consumption and healthy lifestyles might help prevent LOCPs.

Termografia da face de crianças respiradoras orais e nasais / Facial thermography of mouth and nose breathing children

Introdução: A respiração oral é uma alteração prevalente na infância, que tem como uma das consequências a alteração na musculatura dos lábios. A termografia infravermelha, é uma opção para se avaliar a população infantil, pois não gera incômodo, é segura e não emite radiação. Acredita-se que a termografia da face e dos lábios possa auxiliar no diagnóstico e acompanhamento fonoaudiológico. Objetivo: 1) descrever a distribuição de temperatura na face de crianças respiradoras nasais; 2) verificar se os pontos termoanatômicos descritos para adultos pela literatura são facilmente visualizados nas crianças; 3) comparar os resultados da temperatura média dos pontos termoanatômicos da face entre os sexos; e 4) comparar a temperatura dos pontos termoanatômicos e áreas do lábio superior e lábio inferior entre crianças respiradoras orais e nasais. Métodos: estudo observacional transversal realizado com 30 crianças respiradoras nasais e 30 orais de quatro a 11 anos, de ambos os sexos. Utilizou-se a termografia infravermelha da face para obter um termograma frontal, um de perfil direito e outro esquerdo de cada participante. Foram marcados 14 pontos termoanatômicos no termograma frontal e 6 em cada de perfil, mais as áreas de lábio superior e inferior. Foi realizada análise qualitativa visual das imagens, além de análise descritiva e cálculo do ∆T (diferença entre os dois lados da face). Também foi realizada análise de concordância intra e interavaliadores na avaliação dos pontos utilizando-se o Coeficiente de correlação intraclasse. Comparou-se as temperaturas entre os sexos de respiradores nasais, temperatura de respiradores orais e nasais por meio dos Testes T e Mann Whitney. Além disso, comparou-se a diferença entre a temperatura da área de lábio superior e inferior (∆T área) e dos pontos localizados no lábio superior com os do inferior (∆T pontos) entre respiradores orais e nasais utilizando-se os mesmos testes. Resultados: As maiores temperaturas foram no ponto Comissura Palpebral Medial na vista frontal e no ponto Temporal de perfil. O ponto supratroclear não é um ponto que se destaca na face das crianças. O ∆T foi maior que 0,3 para a maioria dos pontos. As regiões hiperradiantes foram testa, olhos e região perioral e as hiporradiantes nariz, bochechas e região do mento. A análise de concordância intra e interavaliadores na avaliação dos pontos variou de boa a ótima. Não foi encontrada diferença de temperatura entre os sexos. Verificou-se que os pontos termoanatômicos mais próximos ao lábio, áreas dos lábios e meato acústico externo apresentaram temperatura menor nos respiradores orais do que nos nasais. Não houve diferença entre os grupos no ∆T de área e pontos. Conclusão: as crianças respiradoras nasais apresentaram como regiões hiperradiantes a testa, os olhos e a região perioral. Os pontos termoanatômicos encontrados nas crianças, são coincidentes com os da população adulta, exceto o ponto Supratroclear, que não é nítido. Os respiradores nasais apresentaram assimetria térmica e não houve diferença entre os sexos. Crianças respiradoras orais apresentaram menor temperatura na região dos lábios e do meato acústico externo do que as respiradoras nasais e não houve diferença entre lábio superior e inferior.

Introduction: mouth breathing is a prevalent disorder in childhood, which has as consequence alteration in the muscle of the lips. Infrared thermography, is an interesting option to assess the child population, as it is safe and does not cause discomfort nor emit radiation. It is believed that thermography of the face and lips can help in the orofacial myology diagnosis and follow-up. Objective: 1) to describe the facial spatial temperature distribution of nose breathing children; 2) verify if the thermoanatomical points described for adults in the literature are easily viewed in nose breathing children; 3) to compare the results of the mean temperature of the thermoanatomical points of the face of nose breathing children between sexes; 4) to compare the temperature of the thermoanatomical points and areas of lips between mouth and nose breathing children. Methods: Cross-sectional observational study of 30 nose-breathing and 30 mouth breathing children of both sexes aged 4 to 11 years. Front view, right side view, and left side view thermogram of each participant were recorded. The mean temperatures of 14 anatomical thermal points in the front view thermogram and 12 points in the side view and lip areas were assessed. A visual qualitative analysis of the images was performed, in addition to a descriptive analysis, and calculation of the ∆T (difference between the two sides of the face). Intra- and interrater agreement analyses of point assessment were made using the intraclass correlation coefficient. Temperatures were compared between sexes of nasal breathers, and temperatures of nose and mouth breathers using the T and Mann Whitney tests. In addition, the difference between the temperature of the upper and lower lip area (∆T area) and between the points located on the upper lip with those on the lower lip (∆T points) of mouth and nose breathers were compared using the same tests. Results: Medial Palpebral Commissure point had the highest temperature in the front view thermogram and Temporal point in the side view. The Supratrochlear point is not a point that stands out on the face of children. ∆T was greater than 0.3 for most points. The warmest regions were forehead, eyes and perioral region and the coldest, nose, cheeks and chin region. The analysis of intra- and inter-rater agreement in the assessment of points ranged from good to excellent. No temperature difference was found between the sexes. It was found that the thermoanatomical points closest to the lip, areas of the lips and External Acoustic Meatus presented lower temperature in mouth breathers than in nose ones. There was no difference between the groups in ∆T area and points. Conclusion: nose breathing children presented the forehead, eyes and perioral region as the hottest regions. The thermoanatomical points found in children are similar to those on the adult population, except for the Supratrochlear point, which does not stand out. Nose breathers showed thermal asymmetry and there was no difference between the sexes. Mouth breathing children have lower temperature in the region of the lips than nose breathing children.

Molusco contagioso: actualización y casos clínicos / Molluscum contagiosum: an update and clinical cases

El molusco contagioso es una patología viral benigna muy frecuente, exclusiva del ser humano, y causada por un virus no clasificado del grupo de los Poxvirus. Las manifestaciones clínicas de la enfermedad inclu-yen lesiones en la piel, que pueden variar desde una pequeña pápula a un nódulo de mayor tamaño, pre-sentándose en forma solitaria o múltiple, dependien-do del estado inmunitario del paciente y del tiempo de evolución del proceso morboso. El estudio histo-patológico es importante para el diagnóstico, aunque en numerosas ocasiones éste se define clínicamen-te. Además del patrón histológico tradicional, y más frecuente, que exhibe hiperplasia e hipertrofia de la epidermis, se han descripto variantes poco usuales, cuyas características dependen, entre otros factores, de la sobreinfección y de la respuesta inmunitaria del paciente. En este trabajo se describen los rasgos ge-nerales del molusco contagioso y luego se presentan varios casos clínicos, uno de los cuales exhibe ma-nifestación inusual en la semimucosa del labio. Por último, se realizan comentarios referentes a la im-portancia que tiene para el odontólogo conocer esta patología y estar capacitado para detectarla, de modo de evitar sus complicaciones y su diseminación (AU)

Molluscum contagiosum is a very common benign viral pathologythat affects exclusively humans and is caused by an unclassified virus of the Poxvirus family. Clinical manifestations include skin lesions such as papule or nodule, which may range from a small papule to a larger nodule, presenting either solitary or multiple, depending on the immune status of the patient and the time of evolution of the morbid process. Histopathological study is important for the diagnosis, although in numerous occasions it is defined clinically. Classical and more frequent histology pattern exhibits hyperplasia and hypertrophy of the epidermis; however, distinct characteristics may occur depending on factors like superinfection and immune response of patients. This article describes general aspects of molluscum contagiosum and exposes several clinical cases, one of which exhibits an unusual manifestation in the semimucosa of the lip. Finally, comments are made regarding the importance for dentists to learn about the existence of this pathology and be able to recognize it in order to avoid its complications and spread (AU)

Amputation labiale par morsure humaine: à propos d'un cas à l'hopital national donka

Les morsures humaines représentent 3 % des morsures rencontrées au service d'urgence. Les preuves et le consensus sur les meilleures pratiques en matière de gestion des morsures humaines font défaut d'échec et de déterminer l'intérêt d'une réparation secondaire. Notre première tentative de reconstitution à partir de la pièce amputée étant échouée alors us avons entrepris cette étude dont les objectifs étaient d'identifier les facteurs OBSERVATION:Une patiente de sexe féminin âgée de 24 ans, ménagère A l'examen endo buccal, on notait une ouverture buccale d'amplitude normale. Les 32 et 31 sont exposées du fait de la perte de substance labiale. L'articulé dentaire conservée, l'hygiène bucco-dentaire défectueuse A l'admission, la patiente détenait dans un verre rempli d'eau minérale la pièce amputée de 2 cm x 1,8 cm dont la couleur laissait présager une vitalité compromise par défaut de vascularisation Les examens biologiques n'ont révélé aucune particularité. Le délai entre l'amputation et l'admission dans le Service était de 7h compromettant plus ou moins la vitalité de la pièce. Un délai nettement inférieur à celui trouvé par Roland et al. dans trois études différentes et qui ont trouvé moins de 14 % des patients ont été admis et plus de 80 % se sont présentés dans les 12 ou 24 heures suivant la morsure. CONCLUSION: Une tentative de replacement intentionnel d'une pièce amputée par morsure humaine sans chirurgie vasculaire est vouée à l'échec par une nécrose évolutive. Cependant la réparation chirurgicale de seconde intention donne un résultat esthétique et fonctionnel satisfaisant.

Evaluación de la sonrisa en pacientes con necesidad de tratamiento ortodóntico / Smile evaluation in patients in need of orthodontic treatment

Este trabajo tuvo como objetivo evaluar características de la sonrisa en pacientes con necesidad de tratamiento ortodóntico. Como objetivos específicos, se planteó estudiar el arco de la sonrisa, la línea del labio superior y los corredores bucales, que son tres componentes importantes a la hora de elaborar un plan de tratamiento adecuado para devolver al paciente una sonrisa funcional y estéticamente aceptable. La muestra quedó conformada por 157 pacientes; de cada uno de ellos se obtuvo una foto de una sonrisa voluntaria. Se encontró que el arco de la sonrisa, en el 39,5 %, presentaba un arco consonante; un 20,4 %, uno plano y el 40,1 % restante, uno no consonante. Al estudiar la línea del labio superior, se observó que, en el 8,3 %, la línea era baja; en el 62,4 %, media y en el 29,3 %, alta. En cuanto a los corredores bucales, se observó que el valor medio, en proporción a la distancia intercomisural del corredor bucal total, era de 15,89 % ± desvío estándar (5,03 %); el valor total máximo, 26,19 % y el valor mínimo, 2,74 %. Conociendo la prevalencia de cada uno de estos datos, se podrá arribar al diagnóstico y posterior plan de tratamiento para cada paciente de manera individualizada(AU)

This work aimed at evaluating smile characteristics in patients in need of orthodontic treatment. As specific objectives, it was raised the issue of studying the smile arch, upper lip line and buccal corridors, which are three important components when preparing an adequate treatment plan to restore the patient a functional and aesthetically acceptable smile. The sample consisted of 157 patients and a photo of a voluntary smile was obtained from each of them. It was found that the smile arch had a consonant arch in 39.5%, 20.4% a flat arch and the remaining 40.1% a nonconsonant arch. When studying the upper lip line, it was observed that in 8.3% the line was low, 62.4% medium and 29.3% high. As regards the buccal corridors, it was observed that the mean value in proportion to the intercommissural distance of the total buccal corridor was 15.89% ± standard deviation (5.03%); maximum total value was 26.19% and minimum value 2.74%. Knowing about the prevalence of each of these data, it will be able to arrive at the diagnosis and subsequent treatment plan for each patient individually(AU)

Manifestación de impétigo y herpes zóster relacionado con el uso de mascarilla durante la pandemia de COVID-19. Informe de caso / Mask-related manifestation of impetigo and herpes zoster during the COVID-19 pandemic. Case report

Objetivo: Presentar un caso clínico en el que el paciente cursa impétigo que podría estar relacionado con el uso de mascarillas faciales por un tiempo prolongado. Caso clínico: Se reporta el tratamiento y la evolución de un caso clínico en un paciente adulto que consultó en un centro clínico privado por la presencia de lesiones vesiculares en la región labial superior con aumento de volumen generalizado en ambos labios. El cuadro clínico es compatible con infección por impétigo y herpes zóster asociado al uso prolongado de una mascarilla de tela. Se describe la importancia del empleo correcto de estas mascarillas que se están usando como medida de protección personal en el contexto de la pandemia por COVID-19, ya que las mismas pueden contribuir a generar infecciones faciales si no se mantiene una higiene apropiada (AU)

Aim: To present a clinical case in which the patient has impetigo that could be related to the use of facial masks for a long time. Clinical case: The treatment and evolution of a clinical case of an adult patient who attended a private clinical centre due to the presence of vesicular lesions in the upper labial region with generalized increase volume in both lips is reported. The clinical presentation is compatible with impetigo and herpes zoster infection associated with prolonged use of a cloth mask. The importance of the correct use of cloth masks that are being used as a personal protection measure in the context of the COVID-19 pandemic is described, since they can contribute to facial infections if proper hygiene is not observed (AU))

Reconstrucción del labio inferior con colgajo miomucoso del buccinador por hemangioma congénito: a propósito de un caso / Reconstruction of the lower lip with myomucosal buccinator flap due to congenital hemangioma: a case report

Los labios son repliegues músculo membranosos móviles que se encuentran en la entrada de la cavidad oral, y tienen como funcionalidad proporcionar competencia para la cavidad oral durante la masticación y el reposo. Bozzola y cols., en 1989, describieron la arteria bucal como el principal pedículo para el músculo buccinador. El objetivo de este trabajo es demostrar la efectividad del colgajo miomucoso del buccinador para reconstrucción del labio inferior en un paciente con hemangioma congénito. Este es un estudio longitudinal de tipo retrospectivo, con resultado descriptivo, que se le realizó a un paciente masculino de 32 años, para cubrimiento de defecto de lesión en labio inferior secundario a hemangioma congénito utilizando la reconstrucción con colgajo miomucoso del buccinador. El colgajo miomucoso del buccinador o colgajo yugal se considera uno de los mejores colgajos locales para la reconstrucción del labio inferior, sea cual fuere la causa, por su fácil disección y versatilidad debido a que tiene una tasa de sobrevida muy elevada con mínimas complicaciones en el posoperatorio. Nuestros resultados obtenidos concuerdan con los resultados ya publicados por diferentes autores, que llegan a las mismas conclusiones; aunque existen varias técnicas con colgajos locales para la reconstrucción del labio inferior, el colgajo del músculo buccinador o yugal se considera como una de las principales alternativas, ya que puede lograrse un labio funcional y estético.

The lips are mobile muscle membranous folds, found at the entrance of the oral cavity, whose function is to provide competition for the oral cavity during chewing and rest. Bozzola et al. in 1989, they described the buccal artery as the main pedicle for the Buccinator Muscle. The objective of this work is to demonstrate the effectiveness of the buccinator myomucosal flap for reconstruction of the lower lip in a patient with congenital hemangioma. This is a retrospective longitudinal study, with descriptive results, which was performed in a 32-year-old male patient to cover a lower lip lesion defect secondary to congenital hemangioma using buccinator myomucosal flap reconstruction. The buccinator myomucosal flap or jugal flap is considered one of the best local flaps for the reconstruction of the lower lip whatever the cause, due to its easy dissection and versatility due to the fact that it has a very high survival rate with minimal complications in the postoperative period. Our obtained results agree with the results already published by different authors, reaching the same conclusions; Although there are several techniques with local flaps for the reconstruction of the lower lip, the buccinator or jugal muscle flap is considered one of the main alternatives, since a functional and aesthetic lip can be achieved.

Abordagens terapêuticas não-cirúrgicas para a queilite actínica / Non-surgical therapeutics approaches for actinic cheilitis

A queilite actínica (QA) é uma desordem potencialmente maligna que se desenvolve principalmente no lábio inferior, decorrente da exposição crônica a luz solar. O objetivo desse estudo é elucidar, a partir de uma revisão da literatura, as abordagens não cirúrgicas mais atuais para o tratamento da QA. Foi realizada uma busca nas bases de dados PubMed, Scielo e Cochrane, sendo obtidos 280 artigos e após aplicação dos critérios de elegibilidade, foram utilizados no presente traba lho 16 estudos. Várias abordagens, como, diclofenaco sódico, mebutato de ingenol, imiquimode, 5-fluorouracil, fludroxicortida e terapia fotodinâmica, são apontadas e estudadas como forma de tratamento para a QA. Entretanto, faltam trabalhos para que se estabeleça um consenso sobre a terapêutica não-cirúrgica mais adequada... (AU)

Actinic cheilitis (AC) is a potentially malignant disorder that develops mainly on the lower lip, result ing from a chronic exposure to sunlight. The objective of this study is to elucidate, from a literature review, the most current non-surgical approaches for the treatment of AC. A search was performed in the PubMed, Scielo and Cochrane databases, obtaining 280 papers and after applying the eligibility cri teria, 16 studies were used in the present study. Various approaches, such as diclofenac sodium, ingenol mebutate, imiquimod, 5-fluorouracil, fludroxycortide and photodynamic therapy are pointed out and studied as a form of treatment for AC. However, there is a lack of work to establish a consensus on the most appropriate non-surgical therapy... (AU)

Tratamento de lesão traumática em UTI: relato de caso / Treatment of traumatic injury in the ICU: case report

O objetivo desse trabalho é relatar um caso clínico de tratamento de úlcera traumática labial utilizando protetor bucal em paciente internado em uma Unidade de Terapia Intensiva. Paciente do sexo feminino diagnosticada com uma doença neurodegenerativa apresentou uma lesão de aspecto ulcerado, de aproximadamente 12 mm na mucosa do lábio inferior. O diagnóstico foi de úlcera traumática decorrente de espasmos musculares involuntários em face. O tratamento proposto foi instalação de protetor bucal confeccionado a partir de uma moldeira pré-fabricada de EVA (etil-vinil-acetato) borrachóide associado à medicação tópica a base de corticosteroide sobre a lesão. Após 5 dias foi observada cicatrização completa da úlcera, dispensando o uso do dispositivo. Nos dias seguintes de internação não foram observadas novas lesões. O protetor bucal instalado mostrou-se efetivo no afastamento do tecido traumatizado de novos traumas, protegeu os tecidos não lesionados e proporcionou qualidade de vida e segurança à paciente. Este relato reforça a importância da Odontologia na assistência do paciente crítico... (AU)

The objective of this work is to report a clinical case of treatment of traumatic lip ulcers using mouth guard in a patient admitted to an Intensive Care Unit. Female patient diagnosed with a neurodegenerative disease presented with an ulcerated lesion, of approximately 12 mm in the mucosa of the lower lip. The diagnosis was a traumatic ulcer resulting from involuntary muscle spasms in the face. The proposed treatment was the installation of a mouthguard made from a prefabricated EVA (ethyl vinyl acetate) rubber mold associated with topical corticosteroid medication on the lesion. After 5 days, complete healing oh the ulcer was observed, dispensing with the use of the intraoral device. In the following days of hospitalization, no new injuries were observed. The installed mouthguard proved to be effective in removing traumatized tissue from new traumas, protecting uninjured tissues and providing quality of life and safety to the patient. This report reinforces the importance of Dentistry in the care of critical patients... (AU)

New diagnostic classification of cheilitis and its clinical diagnostic pathway / 华西口腔医学杂志

Cheilitis is a general term for various types of inflammatory diseases that occur on the lips. The etiology differs and the clinical manifestations and pathological features overlap, leading to difficulties in clinical diagnosis. Reasonable classification is conducive to the diagnosis of cheilitis. However, its classification is difficult because of its cha-racteristics. At present, scholars have proposed two different classification schemes, but a unified classification standard has not yet been established. We classified cheilitis based on its etiology, clinical manifestations, pathological characteristics, and relationship with systemic and special diseases on the basis of special medical reports and by combining clinical practice experience and summarizing previous cheilitis diagnosis and treatment literature. In accordance with this classification method, we proposed suggestions for the clinical diagnosis of cheilitis to provide a reference for the clinical diagnosis and treatment of complex cheilitis.

Prevalence of an incompetent lip seal during growth periods throughout Japan: a large-scale, survey-based, cross-sectional study

BACKGROUND@#Systemic and local factors may lead to disruption of craniofacial growth and development, causing an imbalance between the orofacial skeleton, muscle and soft tissue, dental occlusion, and the dental arch during growth periods. We aimed to reveal whether the prevalence of incompetent lip seal (ILS) varies with age and region, as well as to clarify the factors related to an ILS, in a national, large-scale epidemiological study.@*METHODS@#We surveyed 3399 children, from 3 to 12 years of age, visiting 66 pediatric dental clinics throughout Japan. For this survey, we employed a questionnaire consisting of 44 questions regarding daily health conditions and lifestyle habits. We evaluated the differences in ILS prevalence by age and region (using a Cochran-Armitage test for trend and a Kruskal-Wallis test), and the relationship between ILS and factors investigated in the questionnaire (using Spearman's rank correlation coefficient).@*RESULTS@#We observed that 30.7% of Japanese children exhibited an ILS and that the ILS rate increased with age (p < 0.001). There were no regional differences in the rate of ILS in Japanese children (p = 0.506). We revealed that 12 of 44 survey items exhibited a statistically significant correlation with ILS (p < 0.001), using Spearman's rank correlation coefficient. These items involved orofacial morphology, mouth breathing, and possibly, allergic rhinitis.@*CONCLUSION@#The rate of ILS seems to increase with age in children, throughout Japan. Therefore, this disorder may not self-correct during the growth periods in these children. Guidelines are required for pediatric dentists to recognize ILS among children aged 3-12 years.