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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2007. Vol. 12, no. 5
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- Evaluation of caries risk in a young adult population(2007) Ruiz Miravet, Ana; Montiel Company, José María; Almerich Silla, José ManuelIntroduction: Various caries risk prediction models have been developed in recent years. Cariogram®, a software program that evaluates an individual?s caries risk profile and illustrates it in graphic form, appears to classify patients more correctly than other risk prediction methods. Objectives: The objective of this study was to determine the caries risk of a population by means of the Cariogram® software and examine the relationships between the different variables used by the Cariogram® and the risk of caries determined by this program. Materials and Methods: Data were collected from a sample of 48 young individuals by clinical and radiological examination, saliva sampling and a dietary questionnaire. The caries risk of each individual was then obtained by drawing up the Cariogram®. Results: Past caries experience, Streptococcus mutans counts, Fluoridation programme and Buffer capacity of the saliva are the factors included in the Cariogram that showed significant correlation with the caries risk determined by the program. Other factors that the Cariogram® does not include directly, such as DMFT, DMFS and the plaque index, also showed high correlation with risk. Conclusions: Linear regression analysis makes it possible to draw up more simplified models from the predictive variables with the highest correlation to caries risk. The predictive variable which makes the greatest contribution to the model is Streptococcus mutans count, followed by the DMFT index and the Buffer capacity of the saliva.
- Impact of public preventive programmes on oral quality of life of 11 to 12-yr-old school students(2007) Hita Iglesias, C.; Prados Atienza, María Belén; Bravo Pérez, Manuel; Prados Sánchez, Estrella; Muñoz Soto, Esther; González Rodríguez, Mª PalomaObjetivos: El objetivo es analizar el impacto de programas preventivos sobre la calidad de vida oral en escolares de 11- 12 años. Diseño del estudio: En el curso académico 1996/97 se inició un estudio quasiexperimental en la provincia de Granada con cuatro grupos de escolares de 6-7 años de edad: Sellador + Flúor (selladores en primeros molares permanentes aplicados en el centro de salud, durante 3 años de programa activo, y barniz de flúor aplicado cuatrimestralmente durante 3 años, n=65), Sellador (sólo selladores, n=80), Flúor (sólo barniz de flúor, n=107) y grupo Control (n=59). Todos los escolares fueron explorados cada 6 meses en los colegios durante los 3 años de programa activo, entregándoseles un informe de salud oral tras cada exploración. Tras un periodo de discontinuidad de 2.5 años, en el curso escolar 2002/03 (a los 5.5 años), los escolares fueron explorados, y se les pasó un cuestionario de calidad de vida oral, cuya puntuación va de -6 (mínima) a +6 (máxima). Resultados: Los valores de calidad de vida oral (± desviación estándar) fueron: 3.31±0.30 (Sellador + Flúor), 3.11±0.27 (Sellador), 3.18±0.23 (Flúor) y 2.95±0.32 (Control), sin diferencias estadísticamente significativas entre ellos. Conclusiones: Los programas de Sellador de fisuras y Barniz de flúor no muestran influencia significativa sobre la calidad de vida oral a 5.5 años de seguimiento (3 años de programa activo y 2.5 años de discontinuidad).
- Sporadic oral angiomyolipoma : Case report(2007) Álvarez Álvarez, Carlos; Fernández Sanromán, J.; Fernández Castilla, Manuel; Antón, IosuAngiomyolipoma (AML) is a rare, benign tumour composed of a variable proportion of lipocytes, smooth muscle and thick-walled blood vessels. AML is part of a family of tumours arising from perivascular epithelioid cells (PEComas), and many cases are associated with tuberous sclerosis, with the kidney being the most frequent site involved. We report a case of sporadic AML in the hard palate of a 52-year-old male, an extremely unusual location for this tumour. Differentiation from other benign and malignant oral mesenchymal lesions depends on recognition of the three histologic components, and immunohistochemical techniques may be helpful. AML occurring in the head and neck do not express HMB-45, an antibody that identifies immature melanosomes, conversely to the usual immunopositivity shown in AMLs from kidney and liver, suggesting that there are differences among them. A wide surgical excision is considered curative, as this tumour usually behaves in a benign fashion.
- Aneurysmal bone cyst of the mandible : case presentation and review of the literature(2007) López-Arcas Calleja, José Mª; Cebrián Carretero, José Luis; González Martín-Moro, Javier; Burgueño García, MiguelThe aneurysmatic osseus cyst is a very infrequent bone lesion which in some occasions can be found at the craneofacial skeleton. Among all the cystic lesions that can be found at the mandible or the maxilla it is very rare. On the other side it is at the same time very interesting in terms of its differential diagnose with other types of maxillary bone lesions We present the case of a Caucasian male with an aneurysmatic cyst located at the right angle of the mandible and a review of the literature concerning the case. We have focused on the differential diagnose, mainly with the malignancies that can be found at this location. We also comment the therapeutic options clasically described for these kind of pathologies. In our patient, the surgical excision allowed a complete removal of the lesion and a posterior bone healing which made possible a implant-supported rehabilitation of the edentulous segment.
- Lemierre Syndrome associated with dental infections : report of one case and review of the literature(2007) Juárez Escalona, Inma; Díaz Carandell, Artur; Aboul-Hons Centenero, Samir; Monner Diéguez, A.; Marí Roig, Antonio; Arranz-Obispo, Carlos; Piulachs Clapera, Pedro; Lluch, José Miguel; Cuscó Albors, Silvia; Sieira Gil, R.The first publication on Lemierre Syndrome appears in 1936 by Lemierre. It is defined as an ?oropharynx bacterial infection characterized by the thrombophlebitis in the internal jugular vein, derived in a systemic septic embolism?. In 81% of the cases, the Fusobacterium necrophorum is the most frequent etiologic agent. Fever is the most common symptom, but it can depending on the primary infection, tonsillitis, mastoiditis or odontogenic infection. According to the literature the mortality is very low, but with a significant morbidity, that is why the diagnosis and early treatment is very important. The diagnosis it´s clinical, even though the CT scan and other diagnosis methods (echography, MRI) help to determine the extent of the infection. It?s necessary to administrate the antibiotics endovenous at high dose, (keeping in mind that the most frequent micro organism is anaerobic), and vital support measures if neccessary. We present a case report of Lemierre Syndrome associated to an odonthogenic infection caused by the 4.8 molar.
- Cerebrospinal fluid rhinorrhoea : diagnosis and management(2007) Abuabara, AllanA cerebrospinal fluid (CSF) rhinorrhoea occurs when there is a fistula between the dura and the skull base and discharge of CSF from the nose. CSF rhinorrhea or liquorrhoea commonly occurs following head trauma (fronto-basal skull fractures), as a result of intracranial surgery, or destruction lesions. A spinal fluid leak from the intracranial space to the nasal respiratory tract is potentially very serious because of the risk of an ascending infection which could produce fulminant meningitis. This article reviewed the causes, diagnosis and treatment of CSF leakage. A PUBMED search of the National Library of Medicine was conducted. CSF leak most commonly occurs following trauma and the majority of cases presenting within the first three months. CSF rhinorrhoea have significantly greater incidence of periorbital haematoma. This suggests that patients with head injuries and features of periorbital haematoma are at greater risk of unobserved dural tear and delayed CSF leakage. In the presence of a skull base fracture on computed tomography and a clinical CSF leak, there is no need for a further confirmatory test. In cases where a confirmatory test is needed, the beta-2 transferrin assay is the test of choice because of its high sensitivity and specificity. A greater proportion of the CSF leaks in the patients resolved spontaneously. CSF fistulae persisting for > 7 days had a significantly increased risk of developing meningitis. Treatment decisions should be dictated by the severity of neurological decline during the emergency period and the presence/absence of associated intracranial lesions. The timing for surgery and CSF drainage procedures must be decided with great care and with a clear strategy.
- Dental treatment of patients with coagulation factor alterations : an update(2007) Jover Cerveró, Alba; Poveda Roda, Rafael; Bagán Sebastián, José Vicente; Jiménez Soriano, YolandaHemostasia is a defense mechanism that protects vascular integrity, avoids blood loss, and maintains blood fluidity throughout the circulatory system. The biochemical processes leading to blood clot formation are complex, and alterations can appear at any point within the chain of events. While a range of alterations can affect the coagulation factors, some are more common than others in the general population, including congenital (hemophilia A and B, Von Willebrand?s disease) and acquired disorders (anticoagulant drugs). Such diseases require special consideration in the context of dental treatment, and therefore must be known to dental professionals. Interconsultation with the hematologist will provide orientation on the characteristics of the disease and on the best approach to treatment, including the need for replacement therapy, the application of local hemostatic measures, the modification of anticoagulant therapy, etc. In any case, the most important concern is the prevention of bleeding complications by compiling a detailed clinical history, with adequate planning of treatment, and taking special care to avoid soft tissue damage during the dental treatment of such patients. The dental surgeon must enhance awareness among patients and their relatives of the importance of correct oral hygiene, which will help avoid the need for invasive dental treatments and will reduce the number of visits to the dentist.
- Inferior alveolar nerve paresthesia caused by a dentigerous cyst associated with three teeth(2007) Sumer, Mahmut; Bas, Burcu; Y?ld?z, LeventThe dentigerous cyst is a common pathologic entity associated with an impacted tooth, usually third molars. They generally are asymptomatic, being found on routine dental radiographic examination. This report describes the case of a 43 year old male with a large dentigerous cyst associated with mandibular canine, first and second premolar teeth that caused paresthesia of the inferior alveolar nerve.
- In vivo evaluation of the effects of 10% carbamide peroxide and 3.5% hydrogen peroxide on the enamel surface(2007) Berga Caballero, A.; Forner Navarro, Leopoldo; Amengual Lorenzo, JoséObjetivos: El blanqueamiento de los dientes vitales que realiza el/la paciente en su domicilio bajo la supervisión del/de la dentista con férulas individualizadas especialmente diseñadas para ello y peróxidos de baja concentración, es una opción de entre las que integran esta terapéutica odontológica, ya sea, como tratamiento único o combinada con otra modalidad de blanqueamiento en la consulta. El objetivo del presente trabajo es analizar el efecto que producen sobre la superficie del esmalte dos productos blanqueadores indicados para esta técnica. Diseño del estudio: Se emplearon dos productos blanqueadores, el VivaStyle (Vivadent), peróxido de carbamida al 10%, y el FKD (Kin), peróxido de hidrógeno al 3,5%, que se aplicaron mediante férulas sobre los dientes anteriores de 20 pacientes (10 en cada grupo). El tiempo de aplicación de cada producto fue de 2 y 3 horas al día respectivamente durante 28-33 días. Se obtuvieron réplicas de las superficies dentales antes y después del tratamiento, las cuales fueron observadas con un microscopio electrónico de barrido. Resultados: Las imágenes obtenidas muestran la integridad de la superficie dental, con el mantenimiento de las estructuras normales de la superficie del esmalte. Conclusiones: Los resultados obtenidos muestran que ninguno de los dos productos alteran la superficie del esmalte, no observándose, pues, cambios postoperatorios.
- Oral melanoacanthoma and oral melanotic macule : a report of 8 cases, review of the literature, and immunohistochemical analysis(2007) Carlos, Román; Contreras Vidaurre, Elisa; Netto, Ana Carolina; Mosqueda Taylor, Adalberto; Vargas, Pablo Agustín; Jorge, Jacks; León, Jorge Esquiche; Almeida, Oslei Paes deOral melanoacanthoma (MA) is a rare, benign pigmented lesion, similar to cutaneous MA, characterized by hyperplasia of spinous keratinocytes and dendritic melanocytes. The pathogenesis of oral MA remains uncertain, although its clinical behavior is suggestive of a reactive origin. The most common intraoral sites are the buccal mucosa, lip, palate and gingiva. The average age of presentation is 28 years, mainly in blacks, with a strong female predilection. The oral melanotic macule (MM) is a small, well-circumscribed brown-to-black macule that occurs on the lips and mucous membranes. The etiology is not clear and it may represent a physiologic or reactive process. The average age of presentation is 43 years, with a female predilection. A biopsy is recommended to distinguish these lesions from each other and from other oral melanocytic lesions. We depict four cases each of oral MA and MM, affecting Caucasian and Latin American mestizo patients. The clinicopathological features of these cases reflect its ample spectrum, and to the best of our knowledge, it is the first example of oral MA affecting a Caucasian boy reported in the English literature. Therefore oral MA and MM should be considered in the differential diagnosis of pigmented lesions in the oral mucosa in these populations.
- Dyskeratosis congenita : report of a case with literature review(2007) Auluck, AjitLeukoplakic lesion is not uncommon in clinical practice but its occurrence as a component of a syndrome is rare. Dyskeratosis congenita is a rare genodermatosis, which is characterized by triad of skin pigmentation, nail dystrophy and leukoplakic lesion in the oral cavity. It is important for dentists to now about Dyskeratosis Congenita because these leukoplakic lesions can spontaneously undergo malignant transformation. Majority of cases have been reported in dermatology or pediatrics literature whereas only few reports have appeared in dental literature. The purpose of reporting this case with review of recent literature is to create better awareness among dentists about the multisystem manifestations and oro-dental abnormalities of this fatal condition that can aid clinicians in early diagnosis. A case of 26 year old male is reported with details of differential diagnosis, importance of hematological investigations, periodic biopsies and current concepts in management of such patients are briefly reviewed.
- Classic Kaposi?s sarcoma presenting in the oral cavity of two HIV-negative Quechua patients(2007) Mohanna, Salim; Bravo Puccio, Francisco; Ferrufino, Juan Carlos; Sánchez Lihón, Juvenal; Gotuzzo, EduardoTraditionally, classic KS lesions have a general distribution, often involving the skin of the feet and legs, and to a lesser extent, that of the hands, arms, and trunk. Oral involvement is a rare manifestation. Initial oral involvement is an even rarer occurrence. We report two unusual cases of classic KS presenting in the oral cavity of two patients from indigenous origin; the first patient with primary oral KS lesion on the hard palate, with no other signs of the condition in any other region of the body; the second patient with generalized dermal KS lesions with lymph node and lower lip involvement. In conclusion, clinicians and pathologists should be aware of the typical clinical, gross, and histologic features of KS. Moreover, we would like to emphasize that oral KS may affect patients without AIDS or exposure to immunosuppression. The awareness of oral classic KS as a diagnostic possibility is important in the work-up of vascular lesions in the oral cavity of non-immunosuppressed individuals.
- Florid cemento-osseous dysplasia : a case report(2007) Dagistan, Saadettin; Tozo?lu, Ümmühan; Göregen, Mustafa; Cakur, BinaliCemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissues and involve, essentially, the same pathological process. They are usually classified, depending on their extent and radiographic appearances, into three main groups: periapical (surrounds the periapical region of teeth and are bilateral), florid (sclerotic symmetrical masses) and focal (single lesion) cemental dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For the asymptomatic patient, the best management consists of regular recall examinations with prophylaxis and reinforcement of good home hygiene care to control periodontal disease and prevent tooth lose. Management of the symptomatic patient is more difficult. At this stage, there is an inflammatory component to the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics may be indicated but may not be effective. A case of florid cemento-osseous dysplasia occurring in a 47-year-old Caucasian female is reported which was rare in regard to race and sex.
- Maxillary necrosis by mucormycosis : a case report and literature review(2007) Auluck, AjitThe maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis, viral infections such as herpes zoster or fungal infections such as mucormycosis, aspergillosis etc. Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromised patients. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The infection can spread to orbital and intracranial structures either by direct invasion or through the blood vessels. The fungus invades the arteries leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of maxillary necrosis by mucormycosis in an uncontrolled diabetic patient to emphasize early diagnosis of this potentially fatal fungal infection. We briefly discuss different diseases which can lead to maxillary necrosis and review the current concepts in management of mucormycosis. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection.
- A boy with oral hair : case report(2007) Agha-Hosseini, Farzaneh; Etesam, Farideh; Rohani, BitaIn personal communication we have never seen or heard of hair being detected in the oral cavity. Even Julia Pastrana, the famous ?Bearded Lady? of the 1800?s, had no record of oral hair, although her entire body was covered with hair. Extensive records of her oral condition, including plaster models of her teeth have been preserved in the Odontological Museum of the Royal College of Surgeons in London city. She suffered from excessive gingival hyperplasia, but apparently no hair existed within the mouth. Some rodents have oral hair as a normal occurrence, but the condition is apparently limited in the animal kingdom. A case of hair occurring naturally in the mouth has been reported only twice previously. A third case of this rare anomaly is reported here. In this case, multiple hairs were found at the gingival sulcus in the labial, buccal, lingual and palatal tooth surfaces in an 11-year-old boy.
- Osteonecrosis of the jaw as an adverse bisphosphonate event : Three cases of bone metastatic prostate cancer patients treated with zoledronic acid(2007) García Sáenz, José Ángel; López-Tarruella Cobo, Sara; García Paredes, Beatriz; Rodríguez Lajusticia, Laura; Villalobos León, María Laura; Díaz-Rubio García, EduardoBisphosphonates offer a significant improvement in the quality of life for cancer patients; these potent inhibitors of bone resorption have been shown to markedly reduce the morbidity frequently resulting from bone metastases. Despite the success of bisphosphonates as therapeutic agents, however, toxicity in the form of osteonecrosis of the jaw (ONJ) is a rare complication whose incidence rate has climbed in recent years. ONJ is defined as an unexpected development of necrotic bone in the oral cavity, and is commonly associated with administration of the bisphosphonates Pamidronate and Zoledronate. Clinical features include local pain, soft-tissue swelling, and/or loose teeth; ONJ is also often correlated with previous dental procedures, such as tooth extractions, during biphosphonate therapy. Although additional risk factors--such as corticosteroids, chemotherapy, radiotherapy, trauma or infection?exhibit etiological associations with ONJ, the real pathobiology has not yet been fully elucidated. Here we report our findings on all 2005 OJN cases presented at our institution resulting from bone metastatic prostate cancer treated with zoledronic acid. The incidence of ONJ is nearly 3% (3 out of 104) in these patients.
- Maxillary lesion presenting as a first sign of multiple myeloma : case report(2007) Pinto, Lucielma Salmito Soares; Campagnoli, Eduardo-Baulm; León, Jorge Esquiche; Lopes, Márcio Ajudarte; Jorge, JacksPlasma cell neoplasia is a lymphoid neoplastic proliferation of B cells. This denomination encloses multiple myeloma (MM), solitary bone plasmacytoma and extramedullary plasmacytoma. MM consists of a clonal proliferation of plasma cells based in the bone marrow, with various degrees of differentiation. Neoplastic cells usually produce great amounts of monoclonal light or heavy chains of immunoglobulin that can be detected in serum or urine. The disease is more frequently in men and the average age at diagnosis is about 60 years. The diagnosis is established by blood and urine exams and medullary biopsy. Patients may present renal failure, bone pain, fatigue, recurrent infections and nervous system dysfunction. Oral manifestations may be the first sign of MM, highlighting the importance of the dentist in the early diagnosis of the disease. Treatment involves mainly irradiation and chemotherapy and the prognosis is generally poor. This paper reports a case of a 65 years old black female who had a complaint of a painful mass in the maxilla that prompted a MM diagnosis.
- The digastric muscle?s anterior accessory belly : case report(2007) Reyes Vera, Genny Carolina; Contreras, Camilo; Ramírez, Luis Miguel; Ballesteros, Luis ErnestoDigastric muscle is characterized by presenting occasional variations. The suprahyoid region of an 83 year-old male cadaver was dissected and an anatomic variation of the digastric muscle was observed in its anterior belly. It consisted of an accessory bilateral anterior belly originating in the intermediate tendon and inserted into the mylohyoid raphe. The implications of this variation are discussed from a diagnostic and functional perspective.
