RESUMO
La osteogénesis mediante distracción aplicada a la reconstrucción del proceso alveolar es una técnica sobradamente contrastada en la literatura, al igual que la utilización del transporte óseo en la reconstrucciónde defectos segmentarios mandibulares.Presentamos en este artículo un caso de reconstrucción de un defecto segmentario del maxilar superior mediante transporte de proceso alveolar y su posterior rehabilitación protésica implantosoportada. Mostramos tanto la técnica quirúrgica como el manejo de del vector de distracción utilizando elásticos de ortodoncia y tornillos de bloqueo intermaxilar (AU)
Osteogenesis by means of distraction applied to the reconstruction of the alveolar process is a well-documented technique in the literature, as is the use of bone transport in the reconstruction of mandibular segment defects.In the present article we report on a case of reconstruction of a segment defect in the maxilla using the alveolar transport process, and on the subsequent rehabilitation by means of an implant-supportedprosthesis. Both the surgical technique and the handling of the distraction vector using orthodontic bands and inter-maxillary fixation screws are shown (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Osteogênese por Distração/métodos , Neoplasias Maxilares/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Processo Alveolar , Ortodontia Corretiva/métodos , Aparelhos OrtodônticosRESUMO
La Medicina basada en la Evidencia (MBE) se define como un proceso cuyo objetivo es la selección de los mejores argumentos científicos para la resolución de los problemas que la práctica médica cotidiana plantea. Filosóficamente es un nuevo paradigma (verificacionista), que se ha extendido a todas las profesiones sanitarias (Cirugía Basada en la Evidencia, Odontología Basada en la Evidencia, etc.), soportado por los avances tecnológicos. Aunque sus ventajas son evidentes, también se han reconocido limitaciones, especialmente en lo concerniente a la práctica quirúrgica. En el presente trabajo se revisan los fundamentos y principales ventajas de la MBE. (AU)
Assuntos
Medicina Baseada em EvidênciasRESUMO
BACKGROUND: To evaluate the primary or secondary involvement of the submandibular gland in floor of mouth squamous cell carcinoma. METHODS: An analytic-observational study of prospective type was carried out on 31 patients operated for floor of mouth carcinoma, between June 1993 and January 1996, in a reference hospital for a population of 1,100,000 inhabitants. The investigated variables were: age, sex, tumor localization, clinical TNM, type of cervical surgery, evolution, number of positive cervical metastasis, state of the submandibular gland and presence of the periglandular metastasis. The follow-up period was about 48 to 76 months. The exact Fischer test was used for the statistical study. RESULTS: Histopathological examination identified cervical metastasis as 34.1% of the ipsilateral neck dissections. The average number of positive nodes was 3 (range: 1-9). Cervical periglandular metastases were found in 31.7% of neck dissections, but in no case was microscopic affectation of the submandibular gland found. The existence of intraglandular positive nodes was not found either. In our study, the sensibility and specificity of the clinical exploration of the submandibular region were high (84% and 88% respectively). The presence of cervical metastasis and the size of the tumor conditioned the appearance of recurrences. CONCLUSIONS: In accordance with our study, periglandular metastases in carcinoma of the floor of mouth, are frequent, but submandibular gland involvement is unusual.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Neoplasias da Glândula Submandibular/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estudos ProspectivosRESUMO
Stafne bone cyst of the mandible is the only described destructive bone lesion that is highly localized, nonprogressive, but nonhealing. Such defects usually occur unilaterally, however, bilateral defects are occasionally reported. This paper reports 4 cases of Stafne's bone cyst, one of which showed bilateral presentation. Only four previous cases of bilateral Stafne bone cyst have been reported in the literature. The bibliography is reviewed with regard to the incidence, plausible etiologic factors and methods of diagnosis of such lesions.
Assuntos
Cistos Ósseos/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica , Tomografia Computadorizada por Raios XRESUMO
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.
Assuntos
Adenoma Pleomorfo/patologia , Neoplasias das Glândulas Salivares/patologia , Adenoma Pleomorfo/diagnóstico , Adolescente , Adulto , Distribuição de Qui-Quadrado , DNA de Neoplasias/análise , Feminino , Citometria de Fluxo , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Fase S , Neoplasias das Glândulas Salivares/diagnóstico , Sensibilidade e EspecificidadeRESUMO
Ameloblastic fibro-odontoma is a rare odontogenic tumor. It is formed by proliferation of epithelial odontogenic elements combined with ectomesechimal tissue. The presence of dentine, enamel and osteoid like tissue can be identified. Cases of sarcomatous degeneration have been described. In this work, we present two new cases of ameloblastic fibro-odontoma, analyzing the most important aspects of their differential diagnosis, with a review of literature.
Assuntos
Neoplasias Maxilares/diagnóstico , Odontoma/diagnóstico , Adulto , Matriz Óssea/patologia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Esmalte Dentário/patologia , Dentina/patologia , Diagnóstico Diferencial , Ectoderma/patologia , Feminino , Humanos , Masculino , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/patologia , Mesoderma/patologia , Dente Serotino/diagnóstico por imagem , Odontoma/diagnóstico por imagem , Odontoma/patologia , Radiografia , Dente Impactado/diagnóstico por imagemRESUMO
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.
Assuntos
Neoplasias Gengivais/patologia , Tumor de Células Granulares/patologia , Neoplasias Bucais/patologia , Actinas/análise , Adolescente , Adulto , Antígeno Carcinoembrionário/análise , Corantes , Desmina/análise , Feminino , Humanos , Imuno-Histoquímica , Recém-Nascido , Queratinas/análise , Masculino , Mucina-1/análise , Proteína Básica da Mielina/análise , Neoplasias de Tecido Muscular/patologia , Proteínas de Neurofilamentos/análise , Fosfopiruvato Hidratase/análise , Proteínas S100/análise , Vimentina/análiseRESUMO
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.
Assuntos
Neoplasias Maxilares/patologia , Cisto Odontogênico Calcificante/patologia , Complicações Neoplásicas na Gravidez , Adulto , Feminino , Humanos , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Cisto Odontogênico Calcificante/diagnóstico por imagem , Cisto Odontogênico Calcificante/cirurgia , Gravidez , RadiografiaRESUMO
Actinomycosis is an infectious disease that appears throught the world, in cattle and human beings. It is a chronic granulomatous and suppurative lesion, usually affecting the cervicofacial area. Definitive diagnosis, by culture or biopsy, is not always possible, so the clinician must suspect it by its clinical presentation. It is the purpose of this article to present the patients diagnosed and treated in our Department during the last 5 years, and to review the ideal therapy.
Assuntos
Actinomicose Cervicofacial/microbiologia , Actinomicose Cervicofacial/diagnóstico por imagem , Actinomicose Cervicofacial/tratamento farmacológico , Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/microbiologia , Pessoa de Meia-Idade , RadiografiaRESUMO
The ameloblastic fibroma is an odontogenic tumour with an unusual presentation. It is considered to have both epithelial and mesenchymal elements, but it lacks any calcified dental structures. Two new cases are presented. The first of these began as a mandibular tumour whereas the second was discovered by chance. The radiographic finding in each case was a unilocular cystic radiolucency. Treatment consisted of excisional biopsy by enucleation in both patients. Histopathological findings were consistent with ameloblastic fibroma.