Hyaline and Cystic Degeneration of Uterine Leiomyomas: CT and MR Imaging with Histopathological Sample Analyses.

Leiomyomas are the most common solid benign uterine neoplasms; they are usually asymptomatic and are identified incidentally. Yet, responsive to stimulation by estrogens, leiomyomas may expand, potentially outgrowing their blood supply to undergo hemorrhage, fibrosis, calcification, and atrophy. These pathologic mechanisms commonly lead to leiomyomas degeneration, i.e., red, hyaline, cystic, or myxoid. Magnetic resonance (MR) imaging is the most accurate imaging technique for the characterization of leiomyomas. In cases of degeneration, variable features on T2-weighted and contrast-enhanced images can be found. With no recent radiologic pathologic correlation literature available on this matter, herewith, we provide computed tomography (CT)/MR imaging along with histopathological specimens of two young women who were diagnosed with hyaline or hyaline and cyst degeneration of uterine leiomyomas at our university hospital. We report on the imaging features of uterine leiomyomas using CT and MR imaging and discuss the available literature on imaging signs that may be suggestive of hyaline or cyst degeneration using either of the imaging examination methods.

Carrier systems for bone morphogenetic proteins: An overview of biomaterials used for dentoalveolar and maxillofacial bone regeneration.

Different types of biomaterials have been used to fabricate carriers to deliver bone morphogenetic proteins (BMPs) in both dentoalveolar and maxillofacial bone regeneration procedures. Despite that absorbable collagen sponge (ACS) is considered the gold standard for BMP delivery, there is still some concerns regarding its use mainly due to its poor mechanical properties. To overcome this, novel systems are being developed, however, due to the wide variety of biomaterial combination, the heterogeneous assessment of newly formed tissue, and the intended clinical applications, there is still no consensus regarding which is more efficient in a particular clinical scenario. The combination of two or more biomaterials in different topological configurations has allowed specific controlled-release patterns for BMPs, improving their biological and mechanical properties compared with classical single-material carriers. However, more basic research is needed. Since the BMPs can be used in multiple clinical scenarios having different biological and mechanical needs, novel carriers should be developed in a context-specific manner. Thus, the purpose of this review is to gather current knowledge about biomaterials used to fabricate delivery systems for BMPs in both dentoalveolar and maxillofacial contexts. Aspects related with the biological, physical and mechanical characteristics of each biomaterial are also presented and discussed.

Tubérculo marginal del hueso cigomático / Marginal tubercle of zygomatic bone

El hueso cigomático, ubicado en la parte superior y lateral de la cara, es un hueso par e irregular con forma cuadrilátera o romboidal. Se describen 2 caras, 4 aristas y 4 ángulos, forma cavidades, permite la inserción muscular y aponeurótica, es parte de la arquitectura facial, distribuye las fuerzas masticatorias y permite el paso del nervio cigomático. Su margen postero-superior presenta una prominencia ósea conocida como tubérculo marginal, en el que se observa la inserción de la fascia temporal. El objetivo de este trabajo fue describir las características particulares de esta prominencia. La muestra correspondió a 30 cráneos de adultos chilenos de ambos sexos. A través de una serie de puntos óseos, se describió la presencia, ubicación, tamaño, forma, cortical y trabeculado del tejido óseo del tubérculo marginal. Para realizar las mediciones se utilizaron cámara digital, compas de precisión y cáliper digital. El análisis radiográfico requirió tomografía computarizada de alta resolución. Los resultados mostraron que el tubérculo marginal del hueso cigomático es una prominencia constante, ubicada en el tercio medio del proceso frontal del hueso y que la mayoría de los individuos mostraron una forma semilunar. Su altura fluctúa entre 3 y 4 mm, siendo más pronunciada en hombres que en mujeres. El grosor de la corteza ósea es directamente proporcional a la prominencia del tubérculo, mientras que el trabeculado esponjoso está inversamente relacionado con este último. El análisis de estos resultados parece indicar que las fuerzas biomecánicas ejercidas por la musculatura masticatoria y transmitidas por la fascia temporal, determinan la morfología externa e interna de esta prominencia y del propio hueso cigomático. Concluimos, declarando la necesidad de revisar el conocimiento anatómico a la luz de las nuevas técnicas de imagen e integración disciplinar.

The zygomatic bone, located in the upper and lateral area of the face, is an even and irregular quadrilateral or rhomboid shaped bone. It presents 2 faces, 4 margins and 4 angles. It forms cavities, allows muscular and aponeurotic insertion, is part of the facial architecture, distributes masticatory forces and allows the passage of the zygomatic nerve. Its postero-superior margin presents a bony prominence known as a marginal tubercle, in which the insertion of the temporal fascia is observed. The objective of this work was to describe the particular characteristics of this prominence. The sample corresponded to 30 skulls of Chilean adults of both sexes. Through a series of bone points, the presence, location, size, shape, cortical and trabeculate of the bone tissue of the marginal tubercle was described. A digital camera, precision compass and digital caliper were used to perform the measurements. The radiographic analysis required high-resolution computed tomography. The results showed that the marginal tubercle of the zygomatic bone is a constant prominence, located in the middle third of the frontal process of the bone and that most individuals showed a semilunar shape. Its height fluctuated between 3 and 4 mm, being more pronounced in men than in women. The thickness of the bone cortex was directly proportional to the prominence of the tuber, while the spongy trabeculate was inversely related to the latter. The analysis of these results seems to indicate that the biomechanical forces exerted by the masticatory musculature and transmitted by the temporal fascia, determine the external and internal morphology of this prominence, and of the zygomatic bone itself. In conclusion, it is recommended to review anatomical knowledge in the light of new imaging techniques and disciplinary integration.

The presence of lingual foramina and canals on CBCT on patients over 18 years of age / Presencia en el CBCT de foraminas y canales linguales en pacientes mayores de 18 años de edad

SUMMARY: Lingual foramina and canals are located in the midline of the jaw, which are important due to their neurovascular content. The location of the lingual foramina and canals can be classified according to their relationship to the mental spines; upper, middle or lower. The objective of the study was to determine the prevalence, size and anatomic location of the lingual foramina and canals and in patients older than 18 years of age that were patients at the Universidad de Los Andes, Dentistry Clinic, San Bernardo, Santiago, Chile. Furthermore, to establish sex differences regarding the presence, location and diameter of lingual foramina. From the sample total, 296 foramina were found, from which 133 (45 %) were upper foramina, 43 (15 %) middle foramina and 120 (40 %) lower foramina. In both sexes the prevalence of upper foramina was higher. Regarding the vertical diameter of the foramina, the median of the upper foramina was 0.76 mm, the median of the middle foramina was 0.52 mm and the median of the lower foramina was 0.55 mm. As for the length of the lingual canals, the middle canal was the largest (7.48 mm), followed by the upper (7.53 mm) and the lower (6.83 mm). There was no statistically significant difference between sexes regarding the amount and size of the lingual foramina, neither regarding the size and age of the patients, but there was a difference between the lengths of the canals, being the male patients the ones that presented longer canals in the 3 different kinds. Because of the high prevalence of foramina and canals in the sample, it is recommended to consider them in the planning of surgical procedures on the mandible midline.

RESUMEN: Las foraminas y canales linguales están localizados en la línea media mandibular, los cuales son relevantes dado a su componente neurovascular. Las foraminas linguales pueden ser clasificadas según su localización respecto a las espinas mentonianas pudiendo ser supraespinosas, interespinosas e infraespinosas. El objetivo del trabajo fue determinar la prevalencia, tamaño y relación anatómica de foraminas y canales linguales en pacientes mayores de 18 años de edad que hayan sido tratados en el centro odontológico de la Universidad de Los Andes, San Bernardo, Chile. Además establecer diferencias de sexo en cuanto a la presencia de foraminas linguales, ubicación y diámetro. Del total de la muestra, 296 foraminas fueron encontradas de las cuales 133 (45 %) eran supraespinosas, 43 (15 %) intraespinosas y 120 (40 %) infraespinosas. En ambos sexos la prevalencia de las supraespinosas fue mayor. Respecto al diámetro vertical de las foraminas, la mediana de diámetro para la supraespinosa fue de 0,76 mm, de la intraespinosa fue de 0,52 mm y de la infraespinosa fue de 0,55 mm. Respecto a la longitud de los canales linguales, el canal intraespinoso fue el más largo (7,48 mm), seguido por el supraespinoso (7,53 mm) y finalmente el infraespinoso (6,83 mm). No había una diferencia estadísticamente significativa entre sexos respecto a la cantidad y tamaño de las foraminas linguales. Tampoco lo hubo respecto al diámetro de los canales y la edad de los pacientes. Sin embargo, si lo hubo respecto a la longitud de los canales, siendo los pacientes masculinos lo que presentaban los canales más largos. Debido a la alta prevalencia de las foraminas y canales linguales en la muestra es recomendado considerarles en los planes de tratamiento de procedimientos quirúrgicos en la línea media mandibular.