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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2008. Vol. 13, no. 8
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- Audit of dental reports (II) : first Phase-II study in a Spanish Faculty of Dentistry(2008) Ríos Santos, José Vicente; Martín García, María del pilar; Segura-Egea, Juan J.; Fernández Palacín, Ana; Bullón, PedroAs a measure for correction of deficiencies registered through an audit of dental records in the Comprehensive Dentistry Clinic of the Dentistry Faculty of the University of Seville, we elaborated a new format for dental records which was used in 70 patients, carrying out a monitoring audit (Phase V) by applying the same quality criteria and criteria for data collection used in the initial audit (Phase III). We calculated the indices of fulfilment of 46 quality criteria, extending fulfilment percentage to 41 criteria, while statistically significant differences were found in 25 criteria. The standard prefixed as appropriate (75 %) was reached in 29 criteria (against the 12 criteria in which such standard was reached in the first dental audit). It is essential that faculties of dentistry develop systems for dental record revision which may help students achieve the competence of registering dental-care steps appropriately, teachers identify and give response to educational problems, and clinic administration prevent and correct conflicts, at the same time that they all ensure quality in service provision, ease relations with customers and protect users against legal vulnerability.
- Endoscopically-assisted transoral approach for the treatment of subcondylar fractures of the mandible(2008) Cho Lee, Gui-Youn; Rodríguez Campo, Francisco José; González García, R.; Muñoz Guerra, Mario F.; Sastre Pérez, Jesús; Naval Gias, LuisIntroduction: Treatment of subcondylar fractures of the mandible is one of the most controversial aspects in the field of maxillofacial traumatology. This controversy centers on the positive and negative aspects of open and closed approaches for the treatment of this kind of fractures. Open techniques lead to good reduction and osteosynthesis, but have a high risk of injury to the facial nerve and produce facial scars. Closed techniques (intermaxillary fixation) reduce all the above-mentioned risks but rarely produce correct anatomic reduction, and complications such as ankylosis, condylar necrosis and inhibition of mandibular growth, causing abnormal occlusion, may occur. Despite all the associated risks, closed techniques are currently the most popular treatment. Objectives: To introduce the endoscopically-assisted transoral approach for the treatment of subcondylar fractures, presenting three cases treated in our department. A description of the technique has been included as well as the clinical and radiographic results obtained. Material and Methods: The study is based in three patients with subcondylar fractures of the mandible who were treated by an endoscopically-assisted transoral approach. A description of the surgical technique is included. The results were assessed by postsurgical radiographic control (orthopantomography), maximum mouth opening, occlusion and pain. Results: Three reductions of subcondylar fractures with transoral endoscopically-assisted approach were undertaken. The follow-up period was 6 months. Postsurgical radiographic control showed good reduction of the fracture in all three cases. None of the patients showed any sign of temporomandibular dysfunction after 6 months. Conclusion: Endoscopic treatment by transoral approach combines the positive aspects of both conventional techniques: closed and open reduction; allowing anatomic reduction and a stable fixation leaving no visible facial scars and with a minimum risk of injury to the facial nerve.
- Vestibular bone window for the extraction of impacted lower third molars : four case reports(2008) Peñarrocha Diago, Miguel; Galán Gil, Sonica; Peñarrocha Diago, MaríaFour patients attending for the extraction of an impacted lower third molar are reported. The aim of this paper is was to describe a technical approach, which facilitates impacted lower third molar extraction, minimizing the ostectomy, thus reducing secondary postoperative manifestations and avoiding possible periodontal defects on the distal side of the second mandibular molar. To facilitate the extraction of the crown, roots or the complete molar, a small ostectomy in the form of a window can be made in the vestibular cortical, approaching the extraction through the resultant mesial space.
- Oral Health in people over 64 years of age, institutionalized in Centres for the Aged in the Vigo Health District Spain, 2005(2008) Iglesias Corchero, Ana María; García Cepeda, Juan RamónAbstract Objective: The aim of this study is to determine the prevalence of dental caries, periodontal disease and the condition of and need for dental prosthesis in individuals over the age of 64. Design: A cross-sectional, descriptive and observational study was carried out among all the residents in 3 Centres for the Aged in Vigo-Spain. The standardized criteria of the DMFT (Decayed, Missing and Filled Teeth) index and The Community Periodontal Index of Treatment Needs (CPITN) of the World Health Organization (WHO) were used. Results: 459 subjects were examined with a mean age of 83.8 years, 23% were men and 77% were women; 45% fit for everyday life and 23% require intensive care. In the 85 to 89-year-old group, 53% presented both maxillary and mandibular edentulism and 5% have all of their own teeth. 40% of residents wear a maxillary and mandibular prosthesis and 21% do not wear any kind of dental prosthesis; 38% have complete well-adjusted prosthesis, 28% badly-adjusted prosthesis and 18% need replacing. 38% have inadequate oral hygiene and 20% of prosthesis wearers have a large amount of build-up of dental plaque-calculus. In the subjects studied, the DMFT index was 27.02 with a 36% prevalence of dental caries and a mean of 1.45 caries (SD ± 2.58.), with 76.7% missing teeth, 3.6% filled teeth and 4.2% decayed teeth. The CPITN index shows that 47% of the group have mild periodontal disease (gingival bleeding and calculus) and 9% moderate periodontal disease (periodontal pockets) and in the ratio of teeth CPITN index 71% have excluded sextant, 13% have gingival bleeding and 12% have dental calculus. Conclusion: The results of this study show that dental caries affect more than 30% of the population studied and that periodontal disease in the area of local chronic irritants as well as the presence of periodontal pockets appears in more than half of the subjects studied.
- Cutting efficiency evaluation of Quantec Series 2000 orifice openers with computed tomography (CT)(2008) Hervás García, A.; Forner Navarro, Leopoldo; Llena Puy, María Carmen; Zaragoza Cardells, EduardoIntroduction: Orifice openers or orifice shapers are used to shape the coronal part of the root canals during endodontic treatment. Objectives: The aim of this work was to analyse the cutting efficiency of Quantec Series 2000 system orifice shapers by means of computerised tomography (CT). Materials and methods: Mandibular molars were selected, preoperative CT was performed and the cross-sections and surface area of the root canals were measured. Following access opening and preparation of the coronal part of the canals with Quantec Series 2000 orifice shapers, a further CT was obtained of all the teeth, the previous measurements were repeated and the two sets of measurements were compared. Results: Although the canals suffered modifications due to the action of the instruments, they remained centred and retained their original morphology; the changes were greater in the most coronal part of the canals. Conclusions: the orifice shapers of the system under study kept the canals centred on their original position, so they do not present great aggressiveness during endodontic treatment; the canals that were initially the widest were those that showed the greatest modification; the CT system employed in the study showed itself to be an effective, noninvasive system for studying the changes that had taken place inside the root canals.
- Primary oral squamous cell carcinoma arising around dental osseointegrated implants mimicking peri-implantitis(2008) Eguía Del Valle, Asier; Martínez-Conde Llamosas, Rafael; López Vicente, José; Uribarri Etxebarria, Agurne; Aguirre Urízar, José ManuelProsthodontic rehabilitation using dental implants has become a common practice in dentistry at the present time. The number of complications related to dental osseointegrated implants has increased according to the generalization of its use along the last decade. Among the most common of these complications are chronic inflammatory conditions affecting both hard and soft tissues around dental implants. Although severe complications are uncommon, in recent years several cases of oral squamous cell carcinoma adjacent to dental implants have been published. In this paper we present a new unusual case of primary oral squamous cell carcinoma arising around a dental fixed prosthesis over osseointegrated implants in a 76 male patient with no previous history of malignance and no risk factors related to oral cancer.
- Leprosy-specific oral lesions : a report of three cases(2008) Motta, Ana C.F.; Komesu, Marilena C.; Silva, Claudia Helena lovato; Arruda, Darlene; Simao, Joao Carlos Lopes; Zenha, Erika Muller Ramalho; Furini, Renata Bazan; Foss, Norma TiraboschiLeprosy is a chronic infection caused by Mycobacterium leprae, a bacillus that presents a peculiar tropism for the skin and peripheral nerves. The clinical spectrum of leprosy ranges from the tuberculoid form (TT) to the disseminative and progressive lepromatous form (LL). Oral lesions are rare but, when present, occur in the lepromatous form. This article describes the clinical and microscopic findings of three cases of LL with oral manifestations. All patients had the lepromatous form and their leprosy-specific oral lesions occurred in the palate. The diagnosis was based on clinical, serological and histopathological findings, and multidrug therapy for multibacillary leprosy was started and continued for 24 months. All patients completed treatment, but developed reaction episodes which were treated with prednisone and/or thalidomide. The authors emphasize the importance of oral mucosa evaluation by a dental health professional during patient care since oral lesions may act as a source of infection.
- Advanced osteosarcoma of the maxilla : a case report(2008) Amaral, Márcio Bruno Figueiredo; Buchholz, Ícaro; Freire-Maia, Belini; Reher, Peter; Souza, Paulo Eduardo Alencar; Marigo, Helenice de Andrade; Martins, Carlos Roberto; Horta, Martinho Campolina RebelloOsteosarcomas are primary malignant bone tumours in which mesenchymal cells produce osteoid. It is generally the most common malignant bone neoplasm, although lesions of the jaw are uncommon. Osteosarcoma of the jaw (JOS) presents a lower incidence of metastasis and a better prognosis than osteosarcoma of the long bones. However, patients with JOS can exhibit advanced tumours, mainly when early diagnosis is not performed. This article reports on a case of an advanced osteosarcoma of the maxilla. A 38-year-old woman was referred for evaluation and treatment of recurrent fibrous dysplasia of the facial bones. The patient related that she had been diagnosed with fibrous dysplasia four years earlier and, since the first diagnosis, she was submitted to four surgical interventions, all followed by recurrences. The main clinical findings were redness and swelling of the facial skin, upper lip ulceration, and hard palate swelling. Computed tomography showed a large hyperdense mass in right maxilla extending to right orbit and left maxillary sinus. An incisional biopsy was performed and microscopic examination showed areas of osteoid and chondroid formation surrounded by a cellular stroma. The diagnosis of osteosarcoma was established and the patient was recommended for oncologic treatment. Unfortunately, she died six months after the diagnosis due to uncontrollable local spread.
- Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist : Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School(2008) Fuster Torres, Mª Ángeles; Gargallo Albiol, Jordi; Berini Aytés, Leonardo; Gay Escoda, CosmeIntroduction. Third molar extraction is the most frequent procedure in oral surgery. The present study evaluates the indication of third molar extraction as established by the primary care dentist (PCD) and the oral surgeon, and compares the justification for extraction with the principal reason for patient consultation. Patients and method. A descriptive study was made of 319 patients subjected to surgical removal of a third molar in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Barcelona, Spain) between July 2004 and March 2005. The following parameters were evaluated: sex, age, molar, type of impaction, position according to the classifications of Pell and Gregory and of Winter, and the reasons justifying extraction. Results. The lower third molars were the most commonly extracted molars (73.7%). A total of 69.6% of the teeth were covered by soft tissues only. Fifty-six percent of the lower molars corresponded to Pell and Gregory Class IIB, while 42.1% were in the vertical position. The most common reason for patient reference to our Service of Oral Surgery on the part of the PCD was prophylactic removal (51.0% versus 46.1% in the case of the oral surgeon). Discussion and conclusions. Our results show prophylaxis to be the principal indication of third molar extraction, followed by orthodontic reasons. Regarding third molars with associated clinical symptoms or signs, infectious disease ? including pericoronitis ? was the pathology most often observed by the oral surgeon, followed by caries. This order of frequency was seen to invert in the case of third molars referred for extraction by the PCD. A vertical position predominated among the third molars with associated pathology.
- Septic arthritis of the knee due to Prevotella loescheii following tooth extraction(2008) Fé Marqués, Antonio; Maestre Vera, Juan Ramón; Mateo Maestre, María; González Romo, Fernando; Castrillo Amores, M. A.This is a case report of septic arthritis of the knee due to Prevotella loescheii, in a patient with advanced arthrosis. Two weeks beforehand he had undergone a dental root extraction without antibiotic prophylaxis. His knee had become inflamed 48 hours after extraction and he was started on ibuprofen and steroid treatment (prescribed by his primary health care doctor). With a provisional diagnosis of septic arthritis, synovial fluid was taken for study. Antimicrobial therapy was commenced with amoxicillin/clavulanic acid and the patient progressed satisfactorily. Prevotella loescheii was identified by anaerobic culture. A site of origin for the infection was never found. Joint infection is generally secondary to haematogenous dissemination of bacteria from habitual sites such as odontogenic locations. We suggest that patients with inflammatory arthropathies should be considered as candidates for antibiotic prophylaxis in oral surgery and invasive dental procedures. We suggest, in these cases, the use of antibiotic with spectrum against aerobic and anaerobic bacteria.
- Intraosseous mandibular hemangioma : a case report and review of the literature(2008) Gómez Oliveira, G.; García-Rozado González, Alvaro; Luaces Rey, RamónIntraosseous vascular lesions are rare conditions, comprising only 0.5% to 1% of all intraosseous tumors. They mainly occur in the second decade of life especially in women. The most common locations are the vertebral column and skull; nevertheless, the mandible is a quite rare location. According to the World Health Organization, hemangiomas are benign vasoformative neoplasms of endothelial origin. However, the origin of central hemangioma is debatable. Some authors believe that it is a true neoplasm, whereas others state it is a hamartomatous lesion. Clinically, the patient may be completely symptom-free or may present discomfort, pulsatile bleeding, bluish discoloration, mobile teeth, derangement of the arch form or accelerated dental exfoliation. Most frequently radiographic finding is a multilocular radiolucent image with honeycombs or soap bubble appearance. Differential diagnosis includes neoplasms such as ameloblastoma, cystic lesions such as residual cyst, keratocyst and fibro-osseous lesions such as fibrous dysplasia. There are some therapeutic alternatives, although wide surgical excision remains as the gold standard. We now present a case report of a 51-year-old woman diagnosed in a mandibular hemangioma. Clinical, radiological and histological features of this unusual tumor are described.
- Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics : presentation of five cases and review of the literature(2008) Gaitán Cepeda, Luis Alberto; Quezada Rivera, Daniel; Tenorio Rocha, Fernando; Leyva Huerta, Elba Rosa; Méndez Sánchez, Edgar RamiroLeiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The most common histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of México, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were ? 40 years old at the moment of their diagnosis. The lesions were composed of fusiform cells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed.
- Adenoid cystic carcinoma of the tongue : Case report and literature review(2008) Soares, Eduardo Costa Studart; Carreiro-Filho, Fernando Porto; Costa, Fabio Wildson Gurgel; Vieira, Ana Carolina Maciel; Negreiros Nunes Alves, Ana PaulaAdenoid cystic carcinoma is a common malignant neoplasm originated from salivary glands. The clinical and pathological findings typical of this tumor include slow growth, perineural invasion, and potential local recurrence. It accounts for nearly 2% to 4% of head and neck area tumors. In minor salivary glands it usually affects the palate. We described herein the case of a patient who presented a posterior tongue lesion, which was treated with surgery and radiotherapy as additional treatment. We also carried out a brief literature review on the subject.
- Burning mouth disorder (bmd) and taste : a hypothesis(2008) Femiano, Felice; Lanza, Alessandro; Buonaiuto, Curzio; Gombos, Fernando; Cirillo, NicolaBackground: Burning mouth disorder (BMD) is a burning or stinging sensation affecting the oral mucosa, lips, and/ or tongue, in the absence of clinically visible mucosal lesions. There is a strong female predilection, with the age of onset being approximately 50 years. The causes of BMD are multifactorial and remain poorly understood. Often BMD patients report, in association, change in taste. In this regards, it is relevant that in central nervous system connections exist between taste and oral pain and that taste normally inhibits oral pain. Aim: The working hypothesis of this study considers a possible relationship between burning mouth disorders and alterations of taste. Several conditions or pathologies can be responsible of taste disturbances that might be the cause of oral pain in BMD patients. Subjects and methods: We have analyzed, retrospectively, 142 cases of BMD with associated taste disturbance. Possible causes that could be responsible for alterations of taste were investigated. Results and conclusions: Sixty-one subjects revealed the habitual use of drugs having a documented interference with taste perception. Thirty-five subjects, among the 81 patients who had no associated pathology or habitual use of drugs, noticed in their clinical history conditions, pathologies or use of drugs that are known to affect the gustatory system. Therefore, we propose that BMD may represent an oral phantom pain induced in susceptible individuals by alteration of taste.
