Síndrome de Melkersson-Rosenthal / Melkersson-Rosenthal syndrome

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Histomorphometric evaluation of guided bone regeneration around implants with SLA surface: an experimental study in beagle dogs.

The aim of this study was to evaluate the efficacy of collagen membranes, either alone or combined with a human demineralized freeze-dried bone allograft (DFDBA) or natural bovine bone graft, in bone defects around dental implants with an SLA (sand-blasted, large grit, acid-etched) surface. The experiments were carried out in three beagle dogs using a split-mouth design. On one side of the jaw, three implants were placed and intra-bony defects were created and covered with a collagen membrane, randomly combined in two of the defects with human DFDBA or inorganic bovine bone graft. A control implant, without membrane covering or defect filling, was also placed. On the other side of the jaw, three implants were placed and the bone defects were treated in a similar fashion, but without membrane covering. The studied variables were the percentage of bone-to-implant contact within the limits of the initial bony defect and percentage of the original bony defect occupied by bone tissue. Although no statistically significant differences were found in this study between the membrane and nonmembrane groups, bone defects augmented with anorganic bovine bone and membranes showed the most promising results from a histological and histomorphometric perspective.

Concordancia entre la exploración clínica y la imagen artroscópica en el diagnóstico de los desórdenes internos de la articulación temporomandibular / Concordance between clinical examination and arthroscopy image for the diagnosis of the temporomandibular joint internal derangements

Objetivos: 1. Determinar el grado de concordancia entre el diagnóstico clínico y el artroscópico en el diagnóstico de la disfunción temporomandibular (DTM). 2 Determinar la sensibilidad y especifidad de la exploración clínica en el diagnóstico de los desordenes internos de la articulación temporomandibular (ATM) Diseño. Se ha realizado un estudio experimental no randomizado, tipo ensayo clínico de efidencia a simple ciego. La muestra estaba constituida por 3O enfermos diagnosticados de DTM y sometidos a una artroscopia. Los diagnósticos clínicos y artroscópicos se emitieron según criterios internacionalmente consensuados. La concordancia entre los diagnósticos se evaluó mediante el índice Kappa de Cohen. La relación entre las variables investigadas (cualitativas) se analizó mediante la prueba de la X. Se consideraron diferencias significativas aquellas en las que el valor de p < 0,05. Resultados. La edad media de los enfermos fue de 34,7 años. El 86.1 por ciento de los pacientes eran mujeres. El diagnóstico clínico y artroscópico de desplazamiento discal con reducción, presento una concordancia importante (Kappa = 0,645), mostrando el diagnostico clínico una sensibilidad de 0,71 y una especificidad de 0,93. La concordancia observada entre el diagnóstico clínico de desplazamiento discal sin reducción y, el atroscópico fue casi completa (Kappa - 0,833) con una sensibilidad de 0,83 y una especificidad de 1. Conclusiones. En pacientes con DTM subsidiarios de tratamiento artroscópico el diagnóstico clinico es concordante con el artroscópico en la filiación de los desplazamientos discales (con o sin reduccion). La presencia de chasquidos y el tipo de trayecto de abertura oral son los dos mejores parametros clínicos para el disnóstico (AU)

Oral squamous cell carcinoma of the mandibular region: A survival study.

BACKGROUND: Oral squamous cell carcinomas (SCC) of the mandibular region present the lowest survival rates of the whole oral cavity. The purpose of this analysis was to evaluate the prognostic significance of several diagnostic and therapeutic variables in the survival rates of these carcinomas. METHODS: Forty-nine patients with oral cancers were treated by primary site surgery, involving mandibular resection in all cases. Thirty-one patients underwent postoperative adjuvant radiotherapy. RESULTS: Overall mean survival time and 5-year survival rate were 56.5 months and 44%, respectively. Patients in stages III and IV showed a statistically significant (p = .01) lower survival rate than those in stage II, and positive surgical margins had an adverse effect on survival (p = .03). No differences were found between patients treated by marginal or segmental mandibulectomy. CONCLUSIONS: Among the prognostic predictors studied, only the status of the surgical resection margin (odds ratio, 5.7) and tumor stage (III and IV vs II showed odds ratios of 2.1 and 3.6, respectively) affected the prognosis for SCC of the mandibular region. Tumor site was not associated with prognosis but was related with the probability that surgical margins were involved.

Ameloblastic fibroma: a case report in a 6 year old.

A six-year-old boy was seen by his dentist for a tumor mass in the left mandibular region. The panograph revealed a multilocular radiotransparent lesion extending from the canine to the left mandibular ascending ramus with well defined borders. After biopsy, the lesion was enucleated via curettage of the bone bed. The lesion was diagnosed as ameloblastic fibroma. After six months, radiographs showed that the surgical defect had filled with new bone.

Oncocitoma de la glándula parótida. A propósito de un caso / Oncocytoma of the parotid gland. A report of a case

El onocitoma es una neoplasia de infrecuente presentación. Habitualmente benigna, puede localizarse en cualquier parte del organismo, siendo típica su ubicación en la glándula parótida. En el presente artículo, se documenta el caso de una mujer de 83 años con una masa de 9 x 8,5 x 11,5 cm que afectaba a la totalidad de la glándula parótida izquierda. El examen microscópico mostró una oncocitosis difusa en una neoplasia bien encapsulada. Realizamos una breve revisión de la literatura, incluyendo patogenia, características histológicas y modadlidades terapéuticas de este tumor (AU)

Tissue regeneration in bone defects adjacent to endosseous implants: an experimental pilot study.

Extraction socket defects or alveolar ridge defects may limit or restrict placement of implants. The present study assessed the efficacy of inducing bone formation with demineralized freeze-dried bone (DFDB), osteoinduction with hydroxyapatite (HA), and guided bone regeneration with expanded polytetrafluoroethylene (e-PTFE) in bone defects adjacent to endosseous implants in an animal model. Twenty-four implants were placed in the long bones of 3 pigs. After preparation of 24 cylindric acute defects adjacent to the coronal 5 mm of each implant, 18 of the defects were treated by DFDB, HA, or e-PTFE. The 6 remaining defects healed spontaneously with no treatment (controls). In each pig, one tibia received 4 commercially pure titanium screw implants (3.75 mm x 15 mm), while the contralateral tibia received 4 HA-coated cylindric implants (3.25 mm x 15 mm). Bone formation in response to the 3 treatments and control cases was evaluated using computer-assisted densitometric image analysis. The results showed that a higher density of tissue formed under e-PTFE membranes. A significantly greater increase in bone density was noticed in bone defects treated with an e-PTFE membrane vs DFDB (P = 0.04), in e-PTFE vs control sites (P = 0.04), and in defects treated with HA vs DFDB (P = 0.04) in HA-coated implants. In titanium implants the differences observed were not significant. It was also observed that bone regeneration in defects treated with HA differs with the type of implant used (titanium vs HA-coated implants), but such differences were not significant.

Pleomorphic adenoma of the salivary glands: prospective clinicopathologic and flow cytometric study.

BACKGROUND: Primary surgery is the appropriate treatment for most pleomorphic adenomas of the salivary glands. However, no reliable criteria have been established to predict tumors with aggressive features. METHODS: In 44 patients treated for salivary pleomorphic adenoma, clinicopathologic features and flow cytometric findings were recorded. S-phase fractions were classified as low (0%-1%), intermediate (1.1%-5%), and high (>5%). The relationship between clinicopathologic parameters and flow cytometric DNA analysis was assessed with the Pearson's correlation coefficient. RESULTS: The mean tumor size was 24.4 mm. Microscopically, myxoid structures predominated in 61.4% of cases. Only five specimens showed high S-phase fractions. All samples were DNA diploid (mean coefficient of variation 3.2%). S-phase fraction and tumor size correlated significantly (r = 0.73, P = 0.003). Two patients with recurrent tumors had high S-phase fractions both on the first resected specimens and at the time of the second operation. CONCLUSIONS: The S-phase fraction may be a valuable predictor of aggressive behavior in salivary pleomorphic adenomas. High S-phase fractions were associated with higher tumor size and a greater tendency to recur.

Bone regeneration after radicular cyst removal with and without guided bone regeneration.

In order to determine the degree of bone regeneration after removal of radicular cysts using guided bone regeneration (GBR), a prospective, controlled and randomized clinical study was performed. Thirty patients with radicular cysts were divided into three groups. One group, the control group (n=10 patients), was treated by enucleation and primary closure. The other two groups were treated by enucleation and primary closure but GBR was used in addition, using a resorbable membrane (n=10) and a nonresorbable membrane (n=10). The membranes were fixed with nonresorbable Memfix System screws. The residual volume and the density of the newly formed tissue was measured by computer-assisted tomography and computer-assisted digital image analysis before enucleation and three and six months postoperatively. No statistical significance was found in density and residual volume between the three treatment groups after six months. These results suggest that GBR using membranes does not contribute to increased bone regeneration.

Adenomatoid odontogenic tumor arising in a dental cyst: report of unusual case.

The case of an adenomatoid odontogenic tumor developing over a dentigerous cyst is reported. A 12-year-old boy was referred by his pediatric dentist to the service of Oral and Maxillofacial Surgery of the Asturias Central Hospital (Spain) for evaluation of a radiolucent image compatible with a dentigerous cyst. Microscopic examination revealed the presence of an adenomatoid odontogenic tumor located over the linear epithelium of a dentigerous cyst. Based on the literature, the clinico-pathological, diagnostic, radiological and therapeutic characteristics of the case are commented in detail.

Clinical comparison of dexketoprofen trometamol and dipyrone in postoperative dental pain.

A total of 125 outpatients with moderate to severe pain after surgical removal of one impacted third molar were randomly assigned to receive dexketoprofen trometamol 12.5 or 25 mg or dipyrone 575 mg. For first-dose assessments, patients rated their pain intensity and its relief at regular intervals. From 60 min post dose to the end of the 6-h observation period, both doses of dexketoprofen trometamol had higher pain relief scores than dipyrone: Between 3 and 6 h the differences were statistically significant. In addition, peak measures (PIDmax and PARmax) were statistically superior after both doses of dexketoprofen trometamol compared to dipyrone. The overall efficacy assessed at the end of the first-dose phase was rated as good or excellent by 90%, 83.3%, and 70% of patients receiving dexketoprofen trometamol 25 mg, dexketoprofen trometamol 12.5 mg, and dipyrone, respectively. The number of patients who required remedication during the 6-h period was significantly lower in both dexketoprofen groups. Repeated-dose data were also obtained. No significant differences were found in the efficacy after repeated doses, the number of doses taken, or the mean time elapsed between doses. The overall efficacy at the end of the repeated-dose phase was rated as good or excellent by 84.2%, 66.7%, and 70% of patients receiving dexketoprofen trometamol 25 mg, dexketoprofen trometamol 12.5 mg, and dipyrone, respectively. The frequency of adverse events was similar for all treatments and no serious adverse events were reported during the study.

Granular-cell tumours: an immunohistochemical study.

The granular cell tumour (myoblastoma, Abrikosoff's tumour) and the congenital epulis in newborns (Neumann tumour) are two lesions rarely found in the oral cavity, whose histogenetic origin is highly controversial. This work analyses using immunohistochemical techniques 15 cases of myoblastomas and two of congenital epulis with different mono- and poly-clonal antibodies. Positive immunostaining was found for S-100 protein and neuron-specific enolase in all the cases of myoblastoma, and for vimentin and carcinoembryonic antigen in some cases. No immunoreactivity was observed for any of the other 13 antibodies used in congenital epulis.

Central epithelial odontogenic ghost cell tumour. A case report.

Central epithelial odontogenic ghost cell tumour, a neoplastic variant of calcifying odontogenic cyst, is a rare lesion with a very few cases published in the English literature. Histologically, the tumour consists of clusters of infiltrating odontogenic epithelium and ghost cells in varying numbers. We describe the first case of central epithelial odontogenic ghost cell tumour occurring in a pregnant woman and in which determination of bone densitometry in the preoperative panoramic radiographs has been performed. We have reviewed the literature available in English and compared it with our case.

[Metastasizing pleomorphic adenomas. Clinical and cytometric analysis]. / Adénomes pléomorphes métastasants. Analyses cliniques et cytométriques.

Metastasizing pleomorphic adenoma is a rare lesion, histologically benign but with a malignant clinical behaviour. Two cases are reported with a flow cytometric study. Recurrent adenoma and its metastasis were aneuploid in one case.

Tongue necrosis as a complication of temporal arteritis.

Tongue necrosis is a rare complication in giant cell arteritis, an entity in which both temporal arteritis and rheumatic polymyalgia may be included as two different manifestations of the same pathologic process. The case of a 79-year-old patient who had tongue necrosis 3 hours after ingestion of 2 mg of ergotamine tartrate is presented. This complication was the basis for the diagnosis of temporal arteritis. We reviewed possible clinical manifestations of temporal arteritis and cases of tongue necrosis in the world literature. The possible existence of triggering factors that seemed to be present in 11 of the published cases was analyzed. In seven of these cases ingestion of ergotamine derivates had taken place.

[American Burkitt's lymphoma with mandibular involvement]. / Lymphome de Burkitt Américain de localisation mandibulaire.

Burkitt's tumor is a undifferentiated lymphoma of lymphocytes B with a characteristic histologic pattern often called as "starry sky". It is classified in two groups: endemic Burkitt's lymphoma (African form), and non-endemic Burkitt's lymphoma (American form). The extranodal involvement of the head and neck in the American type is uncommon, so the diagnosis can be delayed. The authors present in this paper a case of American Burkitt's lymphoma in a patient with gingival hyperplasia, and compare the epidemiological, clinical, radiographic, therapeutic and prognostic characteristics of the endemic and non-endemic forms of Burkitt's lymphoma.

[Temporomandibular compression due to condylar osteochondroma]. / Constriction temporo-mandibulaire par un ostéochondrome condylien.

We describe in this work one case of osteochondroma of the mandibular condyle. The first clinical sign was a limitation of the mouth opening. Based on this lesion, a review of the literature is made, and different treatment modalities are discussed.