Clinical difficulties in diagnosis: a rare case of lipoma of the floor of the mouth.

Lipomas are soft tissue mesenchymal neoplasms that rarely occur in the oral and maxillofacial region. Their incidence in the floor of the mouth is very low. The authors present the case of a lipoma of the floor of the mouth, the diagnosis of this lesion was challenging as many clinical signs mimicked the appearance of a common ranula. Also the ultrasound imaging findings were not decisive and only during the operation the yellowish, solid and lobulated aspect of the lesion directed the surgeon to the correct treatment: a block resection of the mass was performed under local anesthesia with no complications. The patient remained asymptomatic with no evidence of recurrences in the postoperative follow-up period of 24 months. Histopathologically, the lesion was classified as a lipoma, a diagnosis based on the presence of mature adipose tissue with no cytologic atypia, subdivided by rare and thin septa of fibrous tissue with the presence of few blood vessels. The case reported highlights the difficulties in diagnosing lesions in the floor of the mouth and the necessity of including rare conditions like lipoma in the differential diagnosis.

X-linked hypohidrotic ectodermal dysplasia: a ten-year case report and clinical considerations.

BACKGROUND: Ectodermal Dysplasias (EDs) are a large group of syndromes that are heterogeneous under clinical and genetic aspects, and are characterised by anomalies in the structures of ectodermal origin. In EDs dental anomalies in shape and number (oligo-hypodontia) occur frequently and severely and can affect both the primary and permanent dentition. CASE REPORT: The oral habilitation of a child affected by X-linked Hypohidrotic-Ectodermal Dyspasia with oligodontia over a period of ten years is described. This report includes discussion of the aetiology of EDs as well as discussion of the long-term prognosis for the patient. CONCLUSION: The success of treatment in the case reported is based on an early diagnosis and a correct timing of interventions addressing the preservation of the existing dental elements, early functional rehabilitation and aesthetic correction.

Cementoenamel junction of deciduous teeth: SEM-morphology.

AIM: The aim of this study was to investigate the cementoenamel junction of a group of 11 primary sound mandibular incisors extracted for orthodontic reasons. MATERIALS AND METHODS: Eleven caries and defect-free human inferior deciduous incisors were extracted for orthodontic reasons and the cementoenamel junction was investigated by scanning electron microscopy (SEM). The types of tissue interrelations were classified in four possible categories: 1) cementum and enamel edge-to-edge, 2) cementum overlapped by enamel, 3) enamel overlapped by cementum, 4) presence of exposed dentin between enamel and cementum. RESULTS: In our observations root cementum and enamel edge-to-edge interrelation was the most frequent feature observed in overall sample, root cementum overlapping enamel tissues was observed in more than one third of the cementoenamel junction area, exposed dentin was a rare observation. In few, small and rare areas enamel overlapped cementum. Further studies could determine statistical prevalence. CONCLUSION: The cementoenamel junction of primary teeth differs from that of permanent teeth, the scarcity of gaps between cementum and enamel, the epithelial junction at the equator of the crown and the globosity of the crown are probable protective factors toward decay susceptibility.

Early childhood caries. Oral health survey in kindergartens of the 19th district in Rome.

AIM: The aim of this cross-sectional survey was to determine the prevalence of early childhood caries (ECC) in a pediatric sample randomly chosen in public kindergartens or the 19th district in Rome, according to the WHO guidelines and to access the dental and orthodontic status of the affected children. METHODS: A total of 546 children aged 3-to 5-years were examined. Clinical examination had been executed from January 1999 to June 2000 by 4 calibrated operators; WHO clinical assessment form and anamnestic questionnaires for parents were performed. RESULTS: Children affected by ECC with a dmft score of 6.3 were 8.2% and 93% were ''treatment need'' (TN); low levels of oral health was significantly related with father's low socioeconomical status, both occupational and educational: most of these families were from less industrialized countries; 40% of these kids used to suck sucking-bottles with honey: many others used to drink too much sweet things (milk and sugar, fruit juice etc.); the most frequent orthodontic features in the ECC group were: brachifacial (26.7%), convex profile (70%), 3rd class terminal plane (30%). CONCLUSIONS: The results obtained point out that information, health education and health promotion are lacking throughout this part of roman population. Primary preventive dentistry programs should be therefore organized targeting parents, nursery schools and kindergartens' operators and pediatricians.