Use of Integra in oral reconstruction: a case series.

OBJECTIVE: Small intraoral defects are usually reconstructed using skin autografts. However, the goal of this research was to describe an alternative to classic techniques using artificial dermis (Integra) in the reconstruction of these types of injuries. MATERIALS AND METHODS: Four patients with small intraoral lesions in different locations underwent resection. The created defects were covered with a bilayer of Integra; then, a chlorhexidine stent cure (Laboratorios Salvat, Barcelona, Spain) was applied. The patients were followed up daily during the first week to detect any signs of infection, dehiscence, or loss of the lamina. Thereafter, they were followed up once a week for 1 month. RESULTS: None of the patients presented with infections or loss of the dermis. When the silicon sheet was detached, granulation tissue was detected, with complete re-epithelialization of the lesion in the postoperative weeks 3 to 4. CONCLUSIONS: The use of the Integra allowed for the rapid reconstruction of slight intraoral defects while preventing the morbidity associated with classic techniques. In this study, no complications were observed.

[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.

[Primary tuberculosis of the oral cavity]. / Tuberculose primaire de la cavité orale

Primary tuberculosis in the oral cavity is a rare entity. Usually, the microorganisms need a disruption of the oral mucosa to become pathogenic. In this article the authors describe a clinical case of primary oral tuberculosis, on a female of 52 years-old who suffered an exodontia 20 days before. The bacteria identificated was Mycobacterium tuberculosis hominis. The microbiologic identification is essential to assure the efficacy of the treatment.

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.

Spontaneous fracture of hypertrophied genial tubercles.

A case of spontaneous fracture of hypertrophied genial tubercles is reported. This is an uncommon event with only six previously reported cases. This entity is usually associated with severe edentulous bone resorption, a condition related to the pathogenesis of this fracture. Clinical complaints include painful swelling of the floor of the mouth and impaired tongue function. If left untreated, mucosal inflammatory changes may appear and a biopsy should be performed. Total recovery is obtained after removal of the fractured fragments.

Atypical histiocytic granuloma of the tongue: case report.

Primary malignant lymphomas of the tongue have rarely been described, and reported cases are usually related to the posterior part of the tongue which is rich in lymphoid tissue, forming part of Waldeyer's ring. Making a distinction between pseudolymphoma and malignant lymphoma is important. Pseudolymphoma is a benign lesion not requiring aggressive therapy. Several lesions in the oral cavity, including atypical histiocytic granuloma, angiolymphoid hyperplasia with eosinophilia, and traumatic ulcerative granuloma with stromal eosinophilia have been described as having certain microscopic features similar to those of pseudolymphoma. Atypical histiocytic granuloma is not associated with systemic disease or dissemination and heals spontaneously despite its microscopic appearance.

[Post-radiotherapy xerostomia in patients with oral cancer. Changes in salivary inorganic components and immunoglobulins]. / Xerostomía post-radioterapia en pacientes con cáncer oral. Modificaciones de los componentes inorgánicos e inmunoglobulinas de la saliva.

Following therapeutic doses of irradiation to the salivary glands the glandular tissues suffer an early degeneration of the serous cells and focal necrosis of the parenchyma. Xerostomia is present and persist for a time, depending upon the dose of irradiation.

[Adenoid cystic carcinoma and basal cell adenoma of the parotid gland: a compromised differential diagnosis]. / Carcinoma adenoideo quistico y adenoma de células basales de la glándula parótida: un diagnóstico diferencial comprometido.

The adenoid cystic carcinoma of the major and minor salivary glands grows slowly but spreads relentlessly into the surrounding tissues, in particular along the perineural spaces. It may appear clinically to be circumscribed, true encapsulation is lacking and the insidious invasion is demonstrated histologically. Another characteristic of the tumor is a high rate of metastases to distant organs such as lung, bobe or liver. The prognosis relatively poor despite surgical excision. The monomorphic basal cell adenoma of salivary glands is a rare tumor. Its diagnosis is, occasionally, difficult with adenoid cystic carcinoma on the clinical and pathology basis. The authors shown a method for this diagnosis consistent in a morphometric analysis of the neoplasic cells.

Optic nerve blindness following a malar fracture.

Optic nerve blindness following a malar fracture is an uncommon and usually permanent complication. When the loss of vision is immediate and total, the prognosis is poor. The case of a patient who suffered immediate and complete loss of vision after a malar fracture is presented. Computed tomography revealed compression of the optic nerve by bony fragments. No improvement was observed after megadose steroids and surgical treatment. The incidence, pathogenesis, diagnostic approach and therapeutic possibilities are discussed and the importance of establishing precisely the moment of the loss of vision is stressed.

[Osseointegration of IMZ implants. Ultrastructural analysis of a case]. / Oseointegración de los implantes IMZ. Análisis ultraestructural de un caso.

A study with scanning electron microscope of an osseointegrated titanium implants (IMZ) was performed, analyzing the characteristics of the interface bone--titanium oxid. It was observed that the characteristics of the interface were similar to the ones shown by other devices whose design is different (Branemark system). The present study confirms that an adequate surgical technique and a satisfactory post-operation on phase (in which the implant is free of load) lead to the osseointegration of the implant; this facts is proved by the absence of mobility of the device, and also by structural findings typical of normal osseous tissue.

[Morphometric study of epithelial neoplasms of the parotid gland]. / Estudio morfométrico de las neoplasias epiteliales de la glándula parótida.

The histological diagnosis of parotid gland tumoral pathology is difficult in some cases. Morphometry provides a possibility to quantify the histopathology minimizing the risk of a misdiagnosis. On this basis, a morphometric study of the normal parotid tissue and 13 types of parotid tumors is carried out and nuclear Area, D. Circle, Form. PE, and Form. AR are calculated. Statistical analysis the results is made using the Student's "t-test" and significant differences between benign and malignant tumors and between each tumor and the remainder are obtained. Contribution of the results to the histopathological diagnosis is discussed.