Pólipos bucales como complicación de una fractura de la tuberosidad / Oral polyps as a complication of a tuberosity fracture

Introducción: la importancia de los senos maxilares se vuelve más clara cuando se entiende que los dientes son responsables del 10 al 12 por ciento de las sinusitis maxilares. Objetivo: caracterizar un caso de pólipos bucales como complicación de una fractura de la tuberosidad. Presentación del caso: se valora una paciente femenina de 62 años que refiere tener una bolita en la boca desde hace 3 semanas, que le ha ido en aumento. Al examen físico bucal encontramos un aumento de volumen en la región posterior maxilar izquierda. Al profundizar en el interrogatorio la paciente refiere que le realizaron una extracción de un molar en el área del aumento de volumen 6 meses atrás, que salió con un fragmento de hueso y que sentía que se le salía el aire, por lo que le suturaron en ese momento. Indicamos medios auxiliares de diagnóstico. Se llegó al diagnóstico de que se trataba el aumento de volumen de pólipos sinusales en una fístula bucoantral como complicación de una fractura de la tuberosidad antigua. Se decidió realizar tratamiento mediante la indicación de antimicrobiano, gotas nasales, inhalaciones, y la realización una técnica de Caldwell Luc, con eliminación de los pólipos presentes, más fistulectomía y cierre mediante colgajo vestibular deslizante. Se tomó muestra para biopsia que informó la presencia de una sinusitis crónica polipoide. Conclusiones: la cirugía bucal es de imprescindible conocimiento para todos los profesionales de la rama estomatológica. El caso presentado de pólipos bucales en una fístula bucoantral como complicación de una fractura de la tuberosidad, de infrecuente presentación en la clínica, contribuye a resaltar la importancia de realizar un correcto interrogatorio para determinar las herramientas diagnósticas y terapéuticas a emplear(AU)

Introduction: the importance of the maxillary sinuses becomes clearer when it is understood that the teeth are responsible for 10 to 12 percent of the cases of maxillary sinusitis. Objective: present a case of oral polyps as a complication of a tuberosity fracture. Case presentation: a 62-year-old female patient attends consultation with a lump in her mouth which she has had for three weeks, during which time it has grown larger. Physical examination reveals a growth in the left posterior maxillary region. During interrogation the patient explained that six months before she was removed a molar from the area of increased volume. The molar had come out with a bone fragment, and she had felt air escaping through the opening, so they sutured right away. We indicated auxiliary diagnostic means. Diagnosis was an increase in the volume of paranasal polyps in an oroantral fistula as a complication of a fracture of the former tuberosity. The treatment indicated was an antimicrobial, nose drops, vaporizations, and performance of a Caldwell Luc technique with removal of the polyps, plus fistulectomy and closure by sliding vestibular flap. A sample was taken for biopsy, which revealed the presence of chronic polypoid sinusitis. Conclusions: training in oral surgery is essential for all dental professionals. The case presented of oral polyps in an oroantral fistula as a complication of a tuberosity fracture, of infrequent clinical presentation, contributes to highlight the importance of proper interrogation to determine the diagnostic and therapeutic tools to be used(AU)

Candida albicans in patients with oronasal communication and obturator prostheses

Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.

Os pacientes portadores de prótese obturadora freqüentemente apresentam estomatite protética. Com o objetivo de detectar a presença de Candida albicans oral em pacientes com comunicação oronasal e avaliar a eficácia de um tratamento tópico antifúngico foi realizada citologia esfoliativa da mucosa palatina e jugal e da superfície acrílica nasal da prótese obturadora. O protocolo terapêutico consistiu de nistatina (Mycostatin®) para tratamento da mucosa oral e uma solução de hipoclorito de sódio para desinfecção da prótese. Sete pacientes (70 por cento) apresentaram resultado positivo para C. albicans na mucosa, com um resultado negativo para a superfície protética neste grupo. A avaliação após o tratamento revelou ausência de C. albicans na mucosa oral de todos os pacientes, bem como na superfície protética. A infecção por C. albicans das mucosas jugal e palatina diferiram significantemente, enquanto que a mucosa palatina e a superfície protética apresentaram valores semelhantes. O grau de infecção da mucosa palatina foi significantemente maior quando comparado àquele da mucosa jugal e semelhante ao apresentado pela prótese, sugerindo que a mucosa subjacente à prótese é mais susceptível à infecção. O protocolo terapêutico foi efetivo em todos os casos, o que enfatiza a necessidade da desinfecção protética para se evitar a reinfecção da mucosa oral.

Loss of permanent mandibular lateral incisor and canine tooth buds through extraoral sinus: report of a case.

Extraoral sinus tract may occur as a result of an inflammatory process associated with the necrotic pulp. Several non odontogenic disorders may also produce an extraoral sinus tract, the differential diagnosis of these clinical findings is of prime importance in providing appropriate clinical care. Presented here is a case report of 4 year old female child with extraoral sinus tract through which the tooth buds of mandibular permanent left lateral incisor and mandibular permanent left canine were lost. The extraoral sinus was due to mandibular left primary canine with class IX fracture (Ellis and Davey's classification).