Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2008. Vol. 13, no. 9

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    Association between periodontitis in pregnancy and preterm or low birth weight : review of the literature
    (2008) Águeda, Anna; Echeverría Manau, Ana; Manau, Carolina
    The aim of this paper is to descibe the pathogenic mechanisms that could explain the relationship between periodontitis and adverse pregnancy outcomes, and to review the evidence from systematic reviews and interventional studies, regarding the association between the clinical indicators of periodontitis and the incidence of low birth weight or preterm births. Preterm birth and low birth weight are world wide leading perinatal problems and have evident public health implications, due to the fact that their incidence doesn?t decrease in spite of the many attempts at their prevention. Both intrauterus infections and bacterial vaginosis of the mother are well known risk factors, but distant infections, even subclinicals, may also produce preterm births. Periodontitis is a chronic infection by anaerobic gram-negative organisms and may produce local and systemic infection, so a possible association between periodontitis and adverse pregnancy outcomes has been suggested. Since 1996, a number of studies have investigated the potential relationship between periodontitis and preterm and low birth weight. However, results have been controversial and more research is needed in order to confirm or discard this association.
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    Evolution of caries and fluorosis in schoolchildren of the Canary Islands (Spain) : 1991, 1998, 2006
    (2008) Gómez Santos, Gladys; González Sierra, Miguel Ángel; Vázquez García-Marchiñena, Javier
    The aim of this work is to assess the evolution of caries and fluorosis prevalence and indices at 7 and 12 years of age in the Canary Islands through three cross epidemiological studies conducted in 1991, 1998 and 2006. The three studies followed a similar methodology, using the WHO diagnosis criteria and indications, except for the assessment of fluorosis, which was measured with the ?Thylstrup and Fejerskov? index. The examining dentists were trained and calibrated in an area with high endemic fluorosis. The three studies took a sample of 1000 students for each age group. At 7 years of age, the decayed, and filled teeth (dft) varied from 1.42 in 1991 to 1.14 in 1998 and 1.37 in 2006. At 12 years of age, the Decayed, Missing, and Filled Teeth (DMFT) went from 1.86 to 1.21 and 1.51 in the three studies respectively and the significant caries index (SiC) went from 4.28 to 3.15 and 3.72. At this age, the Filled Rate rose from 24.05% in 1991 to 30.43% in 1998 and to 37.20% in 2006. In relation to fluorosis, at 12 years of age the percentage of healthy or fluorosis-free schoolchildren in the Canary Islands between the first and the second studies went down from 73% to 61.3% and went up to 78.5% in 2006, with a noticeable fall in the prevalence of children with severe and moderate fluorosis. Despite the fluctuations of caries shown in the three studies, at 12 years of age the Canary Islands have remained in the low level of caries of the WHO classification from 1991 up to now. The evolution in the prevalence of dental fluorosis shows the effect of the measures taken, 10 years after they were started.
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    Clinical features and evolution of oral cancer : a study of 274 cases in Buenos Aires, Argentina
    (2008) Brandizzi, Daniel; Gandolfo, Mariana; Velazco, María Lucia; Cabrini, R.L.; Lanfranchi, Héctor
    Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial diagnosis, due to late diagnosis. Objetives: The aim of the present study was to examine the clinical features and evolution of oral cancer in the University of Buenos Aires. Study design: 274 patients with primary oral carcinoma, over the 1992- 2000 period were included in the study. Results: The survival rate of this population was 80% at 12 months, 60% at 24 months, 46% at 36 months, 40% at 48 months, and 39 % at 60 months (5 years). The tumor localizations with worse prognosis were floor of mouth and tongue, with survival rates of 19% and 27% respectively. Sixty-five percent of the oral carcinomas evaluated were diagnosed at advanced stages (III and IV). Conclusions: The patients under study exhibited the lowest survival rate described for oral cancer (34% five-year survival after initial diagnosis). The population included in this study can be considered representative of the Argentine population. This bad prognosis would be mainly due to the large number of oral cancer cases that were diagnosed at advanced stages.
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    Minor salivary gland tumors : a clinicopathological study of 18 cases
    (2008) Pons Vicente, Olivia; Almendros Marqués, Nieves; Berini Aytés, Leonardo; Gay Escoda, Cosme
    Introduction: Minor salivary gland tumors (MSGTs) are infrequent, representing 10-15% of all salivary neoplasms. Despite this low frequency, MSGTs conform a heterogeneous group of neoplasms characterized by a broad range of histological types. Patients and method: We identified cases of MSGT in a retrospective study of the biopsies made in the period 1997-2007 in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain). The data collected comprised patient age and sex, the clinical characteristics and location of the tumor, the duration of the lesion, its size, the treatment provided, and the histopathological findings. Results: Of the 18 cases of MSGT studied, 12 corresponded to women (66.7%) and 6 to men (33.3%). The great majority (94.4%) were benign tumors. The preferential location was the posterior third of the hard palate (33.2%), followed by the soft palate (16.7%) and the mucosa of the upper lip (16.7%). The histopathological diagnoses of our MSGTs comprised 10 pleomorphic adenomas (55.3%), 2 cystadenomas (11.1%), 1 myoepithelioma (5.6%), 1 sialadenoma papilliferum (5.6%), 1 basal cell adenoma (5.6%), 1 Warthin?s tumor (5.6%), 1 canalicular adenoma (5.6%), and 1 low-grade polymorphic adenocarcinoma (5.6%). Discussion and conclusions: Coinciding with our own results, the literature describes a high recurrence rate for MSGTs (5-30%) when surgical removal is incomplete. Six percent of all benign minor salivary gland tumors are considered to relapse, versus 65% of all malignant lesions. Periodic clinical controls are required, since the possibility of malignant transformation must be taken into account.
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    Treatment of condylar fractures: : a retrospective cohort study
    (2008) Carneiro, Suzana-Célia-de-Aguiar Soares; Vasconcelos, Belmiro Cavalcanti; Caldas-Júnior, Arnaldo-de-França; Leal, Jefferson; Frazão, Marcos
    Objective: Evaluate routine alterations in patients submitted to treatment of unilateral fractures of the mandibular condyle. Patients and methods: The sample consisted of 30 patients of both sexes submitted to surgical and nonsurgical treatment. All patients answered an evaluation questionnaire on perception of the Oral Impact on Daily Performances (OIDP) and underwent physical and imaging examination. The following aspects were evaluated in temporo mandibular join (TMJ) physical examination: maximum mouth opening, left/right lateral movements and protrusive movements. Vertical height measurements of right and left mandibular branches were evaluated by means of orthopantomography. Lateromedial and anteroposterior displacements were measured using Hirtz?s axial radiography. Evaluation of diameter of the mandibular fossa and height of the glenoid fossa were measured by hypocycloidal tomography. Results: A minority (13.3%) answered the questions on OIDP positively, with a similar rate for both treatments. With regard to the vertical height variable, average vertical height was similar for both treatments. However, comparing fractured and nonfractured sides, the difference observed was statistically significant for both treatments. On the basis of the statistical results of this study, for both treatments there were no significant alterations in the maximum mouth opening variable, with an average of 43.35 mm for open treatment and 44 mm for closed treatment. Conclusion: In the present study there were no significant differences between open and closed treatment of unilateral fractures of the mandibular condyle.
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    Treatment of bilateral hyperplasia of the coronoid process of the mandible : Presentation of a case and review of the literature
    (2008) Fernández Ferro, Martín; Fernández Sanromán, J.; Sandoval Gutierrez, Jesús; Costas López, Alberto; López de Sánchez, Annahys; Etayo Pérez, Amaya
    Bilateral hyperplasia of the coronoid process is infrequent. It consists of an elongation of the coronoid process of the mandible and is, accordingly, a mechanical problem, limiting mouth opening. This article looks at the case of a 28 year-old male with significant limitation on opening his mouth, secondary to bilateral hyperplasia of the coronoid process. We reviewed the literature and analysed the diagnostic and therapeutic procedures used, paying special attention to the surgical approaches to the coronoid process and emphasising the importance of early post-operative rehabilitation, describing our experience with the TheraBite® (Atos Medical AB, PO Box 183, 242 22 Hörby, Sweden). The satisfactory result of the procedure is marked by the stable recovery of the mouth opening, achieved by a good combination of surgical and physiotherapeutic techniques.
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    Regional odontodysplasia of the deciduous and permanent teeth associated with eruption disorders : a case report
    (2008) Gündüz, Kaan; Zengin, Zeynep; Çelenk, Peruze; Özden, Bora; Kurt, Murat; Gunhan, Omer
    Regional odontodysplasia (RO) is an unusual, non-hereditary anomaly of the dental hard tissues with characteristic clinical, radiographic and histological findings. Clinically, RO affects the primary and permanent dentition in the maxilla and mandible or both jaws. Radiographically, there is a lack of contrast between the enamel dentin, both of which are less radiopaque than unaffected counterparts. Additionally, enamel and dentin layers are thin, giving the teeth a ?ghost-like? appearance. Histologically, areas of hypocalcified enamel are visible and enamel prisms appear irregular in direction. Coronal dentin is fibrous, consisting of clefts and a reduced number of dentinal tubules; radicular dentin is generally more normal in structure and calcification. The RO etiology is uncertain; numerous factors have been suggested and considered as local trauma, irradiation, hypophosphatasia, hypocalcemia, hyperpyrexia. The treatment of RO has given rise to controversy. These cases require a continuous and multidisciplinary approach. Most clinicians advocate extracting the affected teeth as soon as possible and inserting a prosthetic replacement. Other clinicians prefer restorative procedures, if possible, to protect the affected erupted teeth. A case of RO in an 8 year-old male whose chief complaint was the absence of eruption of permanent teeth is presented. Clinical, radiographic and histological findings are described.
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    Trismus as the first manifestation of cholangiocarcinoma
    (2008) Patrocinio, Lucas G.; Patrocinio, Tomas G.; Pacheco, Leonardo F.; Patrocinio, José A.
    The initial presentation of a cholangiocarcinoma (CC) as trismus due to metastasis to the parotid gland is extremely rare and no previous reports have been found in the literature. A 29-year-old woman presented trismus that initiated 2 months before admission, just after superior left third molar extraction. Physical examination revealed severe trismus and a mass in the parotid gland. Computed tomography (CT) showed a heterogeneous mass in the left parotid gland. The next day she presented jaundice, bilirubinuria, and fever, followed by massive bleeding, intravascular disseminated coagulation, and respiratory insufficiency. Two days later she died. At autopsy, the parotid tumor was identified as a metastasis from a CC of the extrabiliary tract. To our knowledge, this is the first reported case of a metastatic CC that initially presented as trismus due to a mass in the parotid gland. This case represents a rare but important diagnosis that otolaryngologists and oral surgeons should add to the catalog of uncommon causes of trismus.
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    Immediate loading and immediate restoration in 105 expanded-platform implants via the Diem System after a 16-month follow-up period
    (2008) Calvo Guirado, José Luis; Ortiz Ruiz, Antonio José; Gómez Moreno, Gerardo; López Marí, Laura; Bravo González, Luis Alberto
    Objective: The aim of this study was to report on our experience and outcomes with Certain Prevail Implants and immediate loading via the Diem System after a 16-month follow-up period. Materials and Methods: Over a 16- month period, 105 (14 maxilla, 91 mandible) expanded-platform implants were placed in 18 patients (15 females, 3 males; 55.97 ±7.25 SD years). Resonance frecuency analysis (RFA) was measured on the day of placement and at 3, 12 and 16 months. All prostheses were screw mounted on IOL DIEM standard abutments. The follow-up time varied between 3 up to 16 months. Results: One implant (0.9%) failed during final prothetic placement (3 months). The RFA (ISQ) measurements at 16 months evalution for 4 mm- and 5 mm diameter implants were: 76.13 ± 5.0 SD and 76 ±7.7 SD respectively. The RFA data related to mandible and maxilla, the day 0 mean was 76.47 ± 4.75 SD and 70.13 ± 1.35 SD, at 3 months 70.53 ± 4.0 SD and 66.07 ±2.9 SD, at 12 months 68.23± 3.6 SD and 66.40 ±2.7 SD and 16 months 68.23± 3.6 SD and 66.60 ± 2.5 SD respectively. The crestal bone resorption was 0.6 mm at 16 months in platform switching implants.Conclusions: The cumulative implant survival rate during the follow-up period was 99.1% Immediate loading on IOL Diem abutments is a reliable and effective technique for edentulous patients in the maxilla and mandible.
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    Sleep apnea and mandibular advancement device : revision of the literature
    (2008) Rodríguez Lozano, Francisco Javier; Saez Yuguero, Rosario; Linares Tovar, Eva; Bermejo Fenoll, Ambrosio
    Sleep apnea and hypopnea syndrome (SAHS) is a disorder characterized by intermittent and repetitive obstruction of the upper airway provoking pharyngeal collapse. It is characterized clinically by a triad of daytime hypersomnia, snoring and pauses in breathing during sleep that are normally reported by the partner. Polysomnography is the chosen method for diagnosing this pathology. Patients with this disorder tend to have the following dental and orofacial signs: a retrognathic jaw, a narrow palate, a wide neck, deviation of the nasal septum and relative macroglossia, among others. Dentists should be ready to evaluate the risk-benefit of certain dental treatment options for this public health problem. The treatment of this problem will depend on its severity, with one of the options being the Mandibular Advancement Device (MAD) that is used especially in the treatment of slight or moderate SAHS and in the treatment of snoring, with results that are occasionally very successful. The objective of this study is to carry out an up-to-date literature review of SAHS and to evaluate the role of the dentist when faced with this pathology.
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    New findings and controversies in odontogenic tumors
    (2008) Mosqueda Taylor, Adalberto
    Odontogenic tumors comprise a heterogeneous group of lesions that ranges from hamartomas to benign and malignant neoplasms of variable aggressiveness. This article shows how the lack of uniform criteria employed for their proper identification, as well as the histomorphologic similitude found among some of them which behaves in different way, and the scantiness of proper methods to determine their precise origin makes necessary to recognize that at present, in spite of having more or less strict diagnostic criteria which have been internationally accepted, there is a need to continue developing research in the epidemiological, clinico-pathological, morpho-physiological and therapeutical fields in this area of the maxillofacial pathology.
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    Oral manifestations of celiac disease : a case report and review of the literature
    (2008) da Silva, Paulo Cesar; de Almeida, Patrícia Del Vigna; Machado, Maria Angela Naval; de Lima, Antônio Adilson Soares; Grégio, Ana Maria Trindade; Trevilatto, Paula Cristina; Azevedo-Alanis, Luciana Reis
    Celiac disease is a chronic intestinal disease caused by intolerance to gluten associated with poor digestion and absorption of the majority of nutrients and vitamins, which may affect both developing dentition and oral mucosa. The aim of this study is to make a brief review of the literature about celiac disease and to report on a clinical case, showing the impact it may have on the general and oral health. A 39-year-old woman reported the presence of diarrhea, nauseas, flatulence, colic, difficulty with falling asleep, lack of appetite and loose of 18 Kg in the last two years. She also noted the appearance of symptomatic lesions in the mouth. These lesions had a mean duration of a month and occurred in any region of the oral mucosa, particularly on the tongue. Multiples ulcerations were found in the sublingual caruncula region, at the vestibular fornix and at the lingual apex. Topical treatment was instituted for the oral lesions with immediately relief of the symptoms. The diagnosis of celiac disease was established by means of medical clinical exam, biopsy of the small intestine, and by the presence of specific antibodies in the blood. The patient has been instructed to follow a gluten-free diet. Multiprofessional action with the involvement of a gastroenterologist and other health professionals, such as dentists, is important for diagnosing the disease and guiding the patient with celiac disease to achieve a good quality of life.
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    Use of amitriptyline for the treatment of chronic tension-type headache : review of the literature
    (2008) Torrente Castells, Eulalia; Vázquez Delgado, Eduardo; Gay Escoda, Cosme
    Amitriptyline is a tricyclic antidepressant, considered the treatment of choice for different types of chronic pain, including chronic myofascial pain. Its antinociceptive property is independent of its antidepressant effect. Although its analgesic mechanism is not precisely known, it is believed that the serotonin reuptake inhibition in the central nervous system plays a fundamental role in pain control. Although this medication is widely used in the prevention of chronic tension-type headache, few studies have investigated the efficacy of this treatment and the published results are contradictory. The objective of this article was to review the literature published on the use of amitriptyline in the prophylactic treatment of chronic tension-type headache, considering the level of scientific evidence of the different studies using the SORT criteria. From this review, 5 articles of evidence level 1, and another 5 articles of evidence level 2 were selected. Following analysis of the 10 studies, and in function of their scientific quality, a level A recommendation was made in favor of using amitriptyline in the treatment of chronic tension-type headache.
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    Giant cell angiofibroma of the oral cavity : a case report and review of the literature
    (2008) Andrade, Cleverton Roberto de; Lopes, Márcio Ajudarte; Almeida, Oslei Paes de; León, Jorge Esquiche; Mistro, Florence; Kignel, Sergio
    Giant cell angiofibroma is a well-circumscribed, normally encapsulated, distinctive orbital soft tissue tumor. However, it is now recognized that this lesion can also present in other locations, including the oral cavity. The morphological hallmark is a richly vascularized, patternless spindle cell proliferation containing pseudovascular spaces and floret-type multinucleate giant cells. CD34 immunoreactivity, although not specific, represents the only immunohistochemical finding of potential diagnostic value. We present a case of a 44-year-old male Caucasian patient complaining of painless solitary nodule arising on the right buccal mucosa, which was diagnosed as giant cell angiofibroma. To the best of our knowledge, this is the third case of oral giant cell angiofibroma reported in the English-language literature.
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    Differences of the oral colonization by Streptococcus of the mutans group in children and adolescents with Down syndrome, mental retardation and normal controls
    (2008) Linossier, Alfredo G.; Valenzuela, Carlos Y.; Toledo, Héctor
    Objective: to compare the concentration and serotype of Streptococcus mutans in saliva of Down syndrome (DS), mental retarded (MR) and healthy control (C) individuals of the Región Metropolitana Sur of Santiago of Chile. Design of the study: Hundred and seventy nine male and females children and adolescents, aged between 5 to 19 years, 59 DS, 60 MR and 60 C were studied. Saliva samples were cultured in TYCSB agar for quantification, biochemical and serological tests. ANOVA and Chi-square for homogeneity tests were applied. Results: C, DS and MR presented Streptococcus mutans (serotypes c, e, f) and Streptococcus sobrinus (d, g, h), but only among DS and MR non-typifiable (No-tip) Streptococcus mutans were found. MR and DS showed higher bacteria concentration scores than C (P=0.001). Serotypes showed a significant heterogeneity of concentration scores: d, g, h showed the highest and No-tip the lowest one (P = 0.037). Conclusions: No-tip bacteria were absent in C and present in MR and DS; this result indicates different immune and ecological conditions among these human groups. The score of Streptococcus mutans in saliva was higher in DS and MR than in C.