Complex odontoma at the upper right maxilla: Surgical management and histomorphological profile.

BACKGROUND: Odontomas are hamartomatous developmental malformations of the dental tissues. Usually asymptomatic, their presence is often revealed on routine radiographs. The study aimed to establish the efficacy of this conventional approach in treating odontomas, analysing clinical outcome, follow-up, and histomorphological profile. CASE REPORT: A case is presented with a review of the international literature. The patient, aged 8 years, had a complex odontoma localised on the front upper jaw. She was treated following the conventional surgical procedure. Post-operative course and healing were uneventful. Orthodontic treatment was necessary to realign the teeth. At the 12-month follow-up there was no recurrence or failure. Healing was excellent. CONCLUSION: Variations in normal tooth eruption are a common finding, but significant deviations from established norms should alert the clinician to further investigate the patient's health and development.

Clinical, histomorphological and therapeutic features of the Van der Woude Syndrome: literature review and presentation of an unusual case.

BACKGROUND: Van der Woude syndrome (VWS), an autosomal dominant condition associated with lower lip pits and/or cleft palate, is caused by mutations in the interferon regulatory factor 6 gene (lRF6 gene). The genetic alterations identified to date that contribute to expression of the syndrome are chiefly mutations located on chromosome 1 (the largest of our chromosomes), mutations at p36 that codifies the gene GRHL (grainy-head transcriptor factor) and mutations involving IRF6 (interferon regulatory factor). With frequency ranging from 1:35,000 to 1:100,000, depending on ethnicity, gender, and socio-economic status, the syndrome accounts for about 2% of orofacial clefts. The clinical and histomorphological aspects of VWS are studied, and a case of heterozygous female twins of whom only one was affected with VWS is reported. CONCLUSION: This very rare case (no similar case has been reported to date) contributes further evidence on modifying factors in the expression of this condition.

Tongue-tie assessment: clinical aspects and a new diode laser technique for its management.

BACKGROUND Often breastfeeding problems experienced by mothers and their babies may be attributed to the abnormal attachment of the infant's tongue (ankyloglossia) and/or maxillary lip-tie. Proper breastfeeding depends upon an infant's ability to correctly latch onto its mother's breast. If born with oral soft tissue abnormalities such as tongue-tie or lip-tie, it may be almost impossible for the infant to breastfeed. During the oral evaluation of an infant presenting with breastfeeding problems, one factor that is often overlooked and undiagnosed - and thus untreated - is the attachment of the upper lip to the maxillary gingival tissue. CASE REPORT: The case is reported of tongue-tie and breastfeeding difficulties, treated with a novel technique: the diode laser (980 nm).

Oral manifestations of gastrointestinal diseases in children. Part 2: Crohn's disease.

Alterations within the oral cavity can be the first sign of systemic diseases and may thus allow for an early diagnosis and treatment. In particular, being the oral cavity a part of the gastrointestinal system, oral alterations can be an expression of a gastrointestinal disease. Diffuse mucosal swelling, cobblestone mucosa, localised mucogingivitis, deep linear ulceration, fibrous tissue tags, polyps, nodules, pyostomatitis vegetans, and aphthous-like ulcers have been described in Crohn's disease. A prompt recognition of systemic diseases through a careful examination of the oral cavity allows for proper investigations and timely treatment.

Oral manifestations of gastrointestinal diseases in children. Part 1: General introduction.

BACKGROUND: Alterations of the oral cavity are common in children: 22% of children aged less than 4 years and 44% of those aged more than 12 develop dental erosion, 9-95% of children in Europe and in North America develop gingivitis, with adolescents showing a prevalence of more than 60% (Linee guida - Ministero della Salute 2013). Alterations within the oral cavity can be the first sign of systemic diseases and may thus allow for an early diagnosis and treatment. In particular, being the oral cavity a part of the gastrointestinal system, oral alterations can be an expression of a gastrointestinal disease. CONCLUSION: A prompt recognition of sYstemic diseases through a careful examination of the oral cavity could allow the child to have appropriate investigations and to be managed in a timely fashion.

Oral manifestations of gastrointestinal diseases in children. Part 4: Coeliac disease.

Alterations within the oral cavity can be the first sign of systemic diseases and may thus allow for an early diagnosis and treatment. In particular, being the oral cavity part of the gastrointestinal system, oral alterations can be an expression of a gastrointestinal disease. Dental enamel hypoplasia and aphthous ulcers have been found to be more common in children with coeliac disease compared with the general population and to regress after the patient is started on a gluten free-diet. A prompt recognition of systemic diseases through a careful examination of the oral cavity could allow the child to have appropriate investigations and to be treated in a timely fashion.

Allgrove syndrome: a report of a unique case characterised by peculiar dental findings resembling those of ectodermal dysplasia.

BACKGROUND: Triple A or Allgrove Syndrome (OMIM#231550) is a rare, autosomal recessive genetic disorder in which patients typically suffer from chronic adrenal insufficiency due to resistance to ACTH (Addison's disease), esophageal achalasia, and defective tear formation (alacrima). The syndrome is caused by mutations in the AAAS gene on chromosome 12q13 encoding a 546 aminoacid protein named alacrimia-achalasia-adrenal insufficiency neurologic disorder (ALADIN), a constituent of eukaryotic nuclear pore complexes. CASE REPORT: We describe a case of Allgrove Syndrome presenting with anhidrosis and peculiar dental features resembling those of Ectodermal Dysplasia (ED). CONCLUSION: Given the clinical findings in this case we suggest the hypothesis that the pathogenetic mechanism in Allgrove syndrome is related to the ED.

Mucocele of the minor salivary glands in an infant: treatment with diode laser.

BACKGROUND: Mucoceles are benign lesions that develop as a result of retention or extravasation of mucous material from minor salivary glands. Very uncommon in newborns and infants, they rarely may interfere with breastfeeding and compromise the respiratory function. CASE REPORT: We report a case of mucocele in a three-month-old infant in the right labial commissure excised by diode laser of different wavelengths (635-980 nm), with an average power of 1.8 W, in continuous wave mode, using 300 to 320 micron optical fibers. The healing occurred in 10 days. There were no adverse effects and the patient was carefully followed-up until complete healing. CONCLUSION: T he diode laser is not only a valuable tool for mucocele eradication but it also reduces relapses, thanks to the characteristics of the laser light.

Granular cells tumour in the oral cavity: report of eleven cases treated with laser surgery.

AIM: The aim of this paper is to examine the clinical and histological feature of oral tumours of neural derivation and discuss their treatment. METHODS: Between 1999 and 2004, 11 patients (6 females, 5 males; age range 28-66 years) were treated for tumours classified as being of neural origin; they were all myoblastomas or granular cells tumours (ex Abrikossoff tumour). Eight were located on the dorsum of the tongue, 2 on the lateral margin and 1 on the right buccal mucosa. In all cases the mass appeared nodular, single and firm; patients were treated in a single session by excisional resection with 808 and 830 diode laser. RESULTS: During follow-up, which ranged from 5 months to 5 years, there was no indication of tumour recurrence. Histopathological analysis of haematoxylin and eosinstained sections showed all specimens to exhibit features typical of GCT; 6 tumours were well circumscribed, whereas 5 infiltrated adjacent connective tissue, muscle fibres and nerve bundles. In 10 of the 11 cases, the immunohistochemical S-100 protein stain was available and appeared positive. Pseudo-epitheliomatous hyperplasia of different degrees was present in 5 patients, along the overlying epithelium. CONCLUSIONS: Granular cell tumour is a benign neoplasm with a tendency to relapse if not completely removed. The usefulness of laser in the surgical treatment of these tumours particularly if small in size, is underlined.

Oral metastasis of ciliary body melanoma. A case report.

Metastases of melanoma rarely occur in the oral cavity, and very few reports have been published. They are chiefly localized in the tonsil, tongue and lip, regardless of the primary site of the neoplasm. A 76-year-old woman presented a brownish berry-shaped floating neoformation at the upper lip, for which she was hospitalized at the Maxillofacial Surgery Unit, Italian Stomatologic Institute, Milan. Medical history revealed that 6 years previously, in 1998, she underwent enucleation of the right eye due to the presence of a melanoma of the ciliary body. The labial neoplasm was removed and at histological examination it was found to be a spindle cell melanoma with numerous melanophages containing granules of melanin. Both the spindle cells and the melanophages were strongly positive for HMB-45 and for S-100. Thus, the presence of melanic neoplasia at an unusual site together with the medical history of melanoma at the ciliary body, removed 6 years previously, indicated a diagnosis of labial metastasis of melanoma of the ciliary body and the patient was therefore transferred to the Oncology Unit for appropriate treatment.

The neuromelanin of human substantia nigra and its interaction with metals.

Neuromelanin (NM) is a peculiar biochemical component of several neurons in the Substantia Nigra (SN), the target area of the degenerative process in Parkinson Disease (PD). SN NM has peculiarities as to its composition and an impressive capacity of chelating metals, iron in particular, but not exclusively. Gaining insights into the structural and functional characteristics of NM should help understanding the reasons of selective vulnerability of nigral neurons in many parkinsonian conditions. From the present data a protective role of NM can be postulated until the buffering capability toward heavy metals are exhausted. The overloading of NM with iron and other metals in neurons may trigger inflammatory and degenerative processes aggravating the underlying pathological condition.

[Nonfamilial cherubism. A clinical case report]. / Cherubismo non famigliare. Descrizione di un caso clinico.

The authors report a rare case of non-familial cherubism with a six-year follow-up. After an analysis of the hereditary transmission of the disease, the authors evaluate the anatomopathological and radiological characteristics and differential diagnosis, and then discuss possible therapies in the light of the latest research. They underline the important role of CT in identifying lesions which may not be diagnosed by simple X-ray with orthopantomography and highlight the importance of taking extreme care to conserve as much dental and bone tissue as possible during surgery.

[Consequences of fractures of the mandible on the temporomandibular joint]. / Conseguenze sull'A.T.M. delle fratture di mandibola.

Temporo-mandibular joint carry out an important and complex function during masticatory dynamics. For this reason it is very important to consider the possible consequences of the mandibular fractures on the T.M.J. It is possible to have meniscitis or arthritis, arthrosis or even ankylosis.

[Closure of Botallo's ductus arteriosus with indomethacin. Considerations on 4 cases]. / Chiusura del dotto arterioso di Botallo con indometacina. Considerazioni su quattro casi.

Persistence of Patent Ductus Arteriosus (PDA) frequently occurs in preterm infants. In a remarkable number of cases, PDA may undergo spontaneous closure. In other cases, especially in patients with respiratory problems, a ductal left-to-right shunt may compromise the cardiac-respiratory function. Until a few years ago, surgery was the only possible therapy. Recently, pharmacological closure of the duct by means of Indomethacin, a powerful inhibitor of prostaglandin synthesis, was successfully carried out. The medical treatment, however, appears to be less effective if it is carried out on patients older than 2 weeks. It has also been reported that in patient with a very low birthweight and with lack of muscular tissue in the duct wall, closure of the duct may be transient. It is the purpose of this communication to report observations made on 4 preterm infants of 24-33 weeks gestational age, and with a weight range of 660 to 2.280 g. They received Indomethacin via naso-gastric tube, in a single dose of 0,3 mg/Kg, within 8 days of age. Successful closure of the PDA was obtained in all cases. The pharmacological treatment resulted also in reductions in ventilatory support requirements, reduced respiratory component of acidosis, reduced pCO2, increased pO2. A second administrations of Indo was necessary only in one case, and it was followed by permanent closure of the duct. Collateral effects, such as reduced diuresis and reduced number of platelets, were transient. Indo therapy was successful regardless of very low birthweight: in three cases, birthweight was under 1.000 g.(ABSTRACT TRUNCATED AT 250 WORDS)

Spontaneous generation of adriamycin semiquinone radicals at physiologic pH.

Adriamycin semiquinone radicals are spontaneously generated by adriamycin solutions at physiologic pH. Rate of radical formation and equilibrium-state radical yield increase with increasing pH from 7.4 to 8.85. The radicals are oxygen sensitive, but the mechanism of radical formation is oxygen independent and associated with proton removal from the dihydroquinone of adriamycin. The less cardiotoxic and non-mutagenic (Ames test) anthracycline 5-iminodaunorubicin does not form semiquinone radicals spontaneously at physiologic pH.