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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2009. Vol. 14, no. 6
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- Prevalence and distribution of oral mucosal lesions in an adult turkish population(2009) Cebeci,Ali Rıza İlker; Gülsahi,Ayse; Kamburoğlu,Kıvanç; Orhan,Büyük-Kaan; Öztaş,BengiAbstract Objectives: The purpose of this study was to assess the prevalence and distribution of oral mucosal lesions in a Turkish adult population.Material and methods: Five thousand consecutive patients were examined during routine dental treatment. Some of the mucosal changes were diagnosed solely by clinical examination. When clinical features were not diagnostic, a biopsy was undertaken. Chi-square test was used to analyze the data.Results: The overall incidence of oral mucosal changes or lesions was 15.5%. The lesions were classifi ed as anatomic changes, ulcerated lesions, tongue lesions, white lesions, benign lesions, color alterations, and malignant lesions. Anatomic changes (7%), ulcerated lesions (6.6%), and tongue lesions (4.6%) were the most common lesions.White lesions were observed in 2.2% of all patients. Among the white lesions, leukoplakia was identifi ed in men 4 times more frequently than it was in women. Benign lesions and color alterations were identifi ed in 1.6% and 1.2% of all patients, respectively. In addition, 3 patients (0.06%) were diagnosed as having squamous cell carcinoma, and 1 patient (0.02%) was diagnosed as having adenocarcinoma. There was a statistically signifi cant relation between smoking and the occurrence of mucosal lesions whereas no relation was found between alcohol consumption and mucosal lesion occurrence. Besides, no relation was found between systemic diseases and oral mucosal lesion occurrence.Conclusions: This study has provided information about the epidemiologic aspects of oral mucosal lesions that may prove valuable in planning of future oral health studies.
- Oral bisphosphonates-associated osteonecrosis in rheumatoid arthritis(2009) Junquera Gutiérrez,Luis Manuel; Gallego López,Lorena; Coca Pelaz,Andrés; Olay,SonsolesAdverse effects associated with the use of bisphosphonates are infrequent and consist of pyrexia, renal function impairment, and hypocalcemia. Bisphosphonates-associated osteonecrosis of the jaws is an uncommon but potentially serious complication of intravenous bisphosphonate therapy in cancer patients. The degree of risk for osteonecrosis in patients taking oral bisphosphonates, such as alendronate, is uncertain and warrants careful monitoring. Oral bisphosphonates-associated osteonecrosis can occur in patients with rheumatoid arthritis. We report a case of mandibular osteonecrosis in a patient who received alendronate for 3.8 years. The pathology improved after bisphosphonate therapy discontinuation and sequestrectomy. To our knowledge there are only three cases published in the literature relating bisphosphonates-associated osteonecrosis of the jaws in patients with rheumatoid arthritis. All the cases published, including our case, have reported association between methotrexate, prednisone and alendronate sodium (Fosamax®) therapy. Corticosteroid therapy and dental surgery could increase the risk of developing bisphosphonates-associated osteonecrosis of the jaws in these patients.
- Proliferative Verrucous Leukoplakia: diagnostic pitfalls and suggestions(2009) Bishen,Kundendu A.; Sethi,Amit
- Primary melanoma of the oral cavity: ten cases and review of 177 cases from literature(2009) Aguas, Silvia Cristina; Quarracino, María Cecilia; Lence, Adriana Nora; Lanfranchi Tizeira, HéctorOral melanoma is an infrequent but aggressive neoplasm. In contrast to cutaneous melanoma, it does not have a defi ned set of clinical and pathologic classifi cation criteria. We present 10 cases of primary melanoma of the oral mucosa, and review 177 cases published in the international literature. Patients and methods: We compiled a database of patients seen at our department between years 1990 and 2004. A retrospective study of this data was performed. Age, sex, localization and histopathology were all considered. Tobacco consumption and the presence of traumatic factors in the oral cavity were also compared. We compiled another database with 177 cases reported in the international literature during the same time period. Primary and metastatic cases were included.Age, sex and localization were among the factors taken into account. Results: Of the total of 23,685 patients seen at our department in this period, 399 (1.68%) were diagnosed with cancer, 10 (2.5%) of whom were diagnosed with primary oral melanoma. The gender distribution was 1:1, and ages ranged from 30 to 88 years old, with a mean of 67.5 years old. In 80% of the cases, the oral melanoma was localized in the maxillary, and in 20% of the cases, it was localized in the mandible. No connection was found with tobacco consumption. In 60% of the cases, we believe there was a link with prosthetic microtrauma. Of the 177 cases described in the literature, 89% were primary and 11% secondary. The gender distribution was 46.9% female and 53.1% male. Ages ranged from 16 to 91 years old, with a mean of 59.2 years old. Localization: 68.36% maxillary, 11.30% mandible and 20.34% in various oral localizations.
- Central mucoepidermoid carcinoma: report of a case with 11 years’ evolution and peculiar macroscopical and clinical characteristics(2009) Tucci,Renata; Matizonkas Antonio,Luciana Fasanella; Carvalhosa,Artur Aburad de; Castro,Paulo Henrique de Sousa; Nunes,Fabio Daumas; dos Santos Pinto Jr,DécioCentral mucoepidermoid carcinomas (CMC) are uncommon tumours, comprising 2-3% of all mucoepidermoid carcinomas reported. They have been reported in patients of all ages, ranging from 1 to 78-years, with the overwhelming majority occurring in the 4th and 5th decades of life. They are histologically low-grade cancers, usually affecting the mandible as uniocular or multiocular radiographic lesions. The authors report a case of CMC of the mandible with a long evolution, and peculiar clinical and macroscopical features related with the long term evolution of the disease. A 53-year-old male patient had expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated mucosa, with 11 years evolution. An incisional biopsy was performed, and the histopathological fi ndings confi rm low-grade mucoepidermoid carcinoma. The patient was treated with a mandibulectomy, followed by supraomohyoid neck dissection. There was no evidence of local recurrence, regional or distant metastasis revealed; and the patient was alive and without disease after a followup interval of 36 months.
- Prevalence of medically compromised conditions in dental patients(2009) Dhanuthai,Kittipong; Sappayatosok,Kraisorn; Bijaphala,Panruthai; Kulvit,Sirinya; Sereerat,ThanasitObjectives: To study the prevalence of medically compromised conditions in patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University. Study design: The fi les of 58,317 patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University from 2002-2004 were retrieved and reviewed for medically compromised conditions. Results: From a total of 58,317 patients, 7,167 patients (12.2%) had medically compromised conditions. The fi ve most prevalent conditions in descending order were allergy, hypertension, diabetes mellitus, heart diseases and thyroid diseases. Conclusions: Even though the prevalence of medically compromised conditions in dental patients is not high, dentists should bear in mind that some of the patients may harbor such conditions which are contraindicated for certain dental procedures or medication or require special attention when treating these patients. Therefore, a thorough history taking and careful clinical examinations are mandatory before commencing any dental treatment.
- Artifacts in brain magnetic resonance imaging due to metallic dental objects(2009) Costa,André Luiz Ferreira; Appenzeller,Simone; Yasuda,Clarissa Lin; Pereira,Fabrício Ramos Silvestre; Zanardi,Verônica A.; Cendes,FernandoObjective: Artifacts caused by metallic objects, such as dental crowns, dental implants and metallic orthodontic appliances, are a common problem in head and neck MRI. The aim of this retrospective study was to identify the main metal dental objects that produce artifacts on brain MRIs.Study design: Imaged metallic artifacts and their sources were identifi ed. Artifact image plane was rated on a score of 0 or 1 (0 - distinguishable for diagnosis and 1 - not distinguishable for diagnosis).Results: Seventy-eight percent of the artifacts appearing in images were caused by orthodontic appliances, followed by dental titanium implants (18%) and metallic crowns (4%). Orthodontic appliances obtained the highest scores in all planes.Conclusions: We concluded that is diffi cult to avoid the effect of metallic artifacts in the maxillofacial regions on brain scan. Removing metallic parts of the orthodontic appliance should ensure diagnostically useful quality scans.
- A comparative study of the long term results of root coverage with connective tissue graft or enamel matrix protein: 24-month results(2009) Abolfazl, Nader; Saleh Saber, Fariba; Eskandari, Amir; Lafzi, ArdeshirBackground: The objective of this study was to compare the 24 month results of coronally advanced fl ap + enamel matrix derivates (EMD+CAF) and CAF+ connective tissue graft (CTG+CAF) in the treatment of Miller Class I recession defects.Methods: Twelve patients with bilateral gingival recessions were treated with EMD+CAF or CTG+CAF. Vertical recession depth (VRD), keratinized tissue width (KTW), clinical attachment level (CAL), and clinical probing depth (CPD) were measured preoperatively, 1 and 2 years post surgery. A paired t-test and independent t-test were used to compare differences for the measured characters within and between groups, respectively.Results: After 24 months a signifi cant decrease in VRD was observed in CAF + EMD (3.33±0.30 mm) and CAF + CTG (4.5 ± 0.28 mm) treated sites. There was also a signifi cant increase in KTW (0.83±0.23 mm versus 2.08±0.14 mm in EMD+CAF and CTG+CAF sites, respectively). The gain in CAL was 3.54 ± 0.38 mm and 4.45±0.30 mm in EMD+CAF and CTG+CAF group, respectively. There were signifi cant differences between the treatments for VRD, CAL, and KTW at the end of study.Conclusions: The CTG+CAF procedure seems to provide better long-term results than the EMD+CAF in obtaining root coverage, increasing the KTW and CAL gain.
- Erupted odontomas: a report of three cases and review of the literature(2009) Serra Serra,Gabriel; Berini Aytés,Leonardo; Gay-Escoda,CosmeIntroduction: Odontomas are benign odontogenic tumors composed of enamel, dentine, cement and pulp tissue.They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. In exceptional cases the odontoma erupts into the mouth. The present study reports three cases of odontomas erupted into the oral cavity and reviews the literature.Clinical cases: The fi rst case was an 11-year-old girl with impacted 4.6 associated to a radiopaque mass measuring about 2 cm in diameter. The histological diagnosis was complex odontoma. A clinical and radiological follow-up of 4.6 was carried out until its spontaneous eruption. The second case was a 26-year-old male presenting a hard, yellowish-brown mass located distal to the upper left second molar. Computed tomography confi rmed the presence of a radiopaque lesion, and the histopathological study confi rmed a complex odontoma. The third patient was a 27-year-old male reporting tongue irritation due to tooth eruption in the inferior lingual region. A periapical radiograph revealed a mixed radiopaque lesion associated to impacted 3.2. The histological report in this case indicated a compound odontoma.Discussion: Odontomas erupting into the oral cavity are rare. The fi rst case was published in 1980, and since then only 17 cases have been reported in the literature. Eight of the 17 cases were complex odontomas; the rest were compound odontomas. Pain, swelling and infection were the most common symptoms, and 13 cases presented an impacted tooth associated with the lesion.
- Oral implant rehabilitation in a patient with Moebius syndrome(2009) Escoda Francolí,Jaume; Sánchez-Garcés,María Ángeles; Gay-Escoda,CosmeIntroduction: Moebius syndrome is a rare congenital disorder characterized by unilateral or bilateral involvement of the sixth and seventh cranial nerves, resulting in a lack of facial expression and eye movements. These patients suffer a series of oral manifestations that may complicate their dental treatment, such as facial and tongue muscle weakness, uncontrolled salivation secondary to defi cient lip sealing, micrognathia, microstomia, bifi d uvula, gothic and fi ssured palate, fi ssured tongue, and glossoptosis. The underlying etiology remains unclear, though vascular problems during embryogenesis appear to be involved.Clinical case: We report the case of a woman with Moebius syndrome and total edentulism. Eight years ago she underwent complete oral rehabilitation with the placement of two implants in each dental arch.Discussion: Moebius syndrome has still an unknown etiology, although it is related to disorders during pregnancy.This kind of patient can be rehabilitated using oral implants.
