Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2006. Vol. 11, no. 3
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- Choice of ceramic for use in treatments with porcelain laminate veneers(2006) Fons Font, Antonio; Solá Ruiz, María Fernanda; Granell Ruiz, María; Labaig Rueda, Carlos; Martínez González, AmparoEl tratamiento mediante Frentes Laminados de Porcelana (FLP) se utiliza desde hace más de dos décadas para el tratamiento de problemas estéticos y/o funcionales, particularmente en el grupo anterior de las arcadas dentarias (1,2,3). La actual oferta en el mercado de cerámicas dentales aptas para este tipo de tratamiento, pero muy distintas en cuanto a composición, características ópticas y sistema de elaboración, hace complicada la selección del material más adecuado a cada paciente en particular. Proponemos un sistema sencillo de elección de la cerámica teniendo en cuenta las dos variables que más influirán en el resultado estético final: de un lado las características propias del diente (sustrato en el que nos apoyamos), y de otro las características propias del material cerámico en cuanto a resistencia y propiedades ópticas.
- Osteochondroma of the coronoid process(2006) Villanueva, Julio; González, Andrea; Cornejo, Marco; Núñez, Cristián; Encina Moriámez, SusanaOsteochondroma is the most common benign neoplasia of the skeleton. In the head it was been described in cranial base, posterior maxillary surface, maxillary sinus, and different mandibular areas like condyle, ramus, body and symphysis. Osteochondroma of the coronoid process are rare. We present a review of the literature and the report of the cas of a 44 years old female patient presenting limited mouth opening and swelling of the left cheek, with diffuse limits, bony consistency, painless, and covered of normal skin. No temporomandibular joint disease was present. In panoramic radiographs was evident a coronoid tumor localized in the union of zigomatic arch and bone. Under general anaesthesia coronoidectomy was made, recovering mouth opening until 43 mm. The post-operative period was performed without complications. Histopatological examinations revealed normal trabecular bone covered with hyaline cartilage. The histopatological diagnosis was osteochondroma. Clinical and pathological aspects, treatment and differential diagnosis with other lesions are discussed.
- Antibiotic prophylaxis in Oral and Maxillofacial Surgery(2006) Salmerón Escobar, José Ignacio; del Amo Fernández de Velasco, ÁlvaroLa profilaxis antibiótica en cirugía oral y maxilofacial tiene como fin la prevención de la infección en la herida quirúrgica, ya sea por las características de la cirugía o por el estado general del paciente. Este riesgo se incrementa cuanto más se contamine el campo quirúrgico, siendo necesario realizar tratamiento profiláctico de la infección en cirugías limpiascontaminadas y contaminadas y tratamiento de la infección en cirugías sucias. Además, una adecuada técnica quirúrgica colabora con la reducción de la aparición de infección postquirúrgica. La antibioterapia de elección varía entre derivados de la penicilina con inhibidores de las betalactamasas (amoxicilina-clavulánico, ampicilina-sulbactam), cefalosporinas de segunda o tercera generación, quinolonas o clindamicina. La indicación de su uso variará en función del tipo de cirugía en cada ámbito de la cirugía oral y maxilofacial, según el grado de contaminación de la misma. De este modo en cirugía oral y en patología de glándulas salivares la literatura parece demostrar que no hay mejor pronóstico en cuanto al uso de antibioterapia profiláctica respecto a no usarla en pacientes sanos. En traumatología se justifica en fracturas compuestas o con comunicación con senos paranasales. En cirugía ortognática hay discrepancia en cuanto al criterio de empleo de profilaxis antibiótica, si bien se prefieren ciclos cortos de tratamiento. En cuanto a la cirugía oncológica, se ha demostrado la reducción de la incidencia de infección postquirúrgica con el uso de antibioterapia profiláctica peroperatoria, fundamentalmente en los casos en que se pone en contacto la mucosa oral con la región cervical.
- Stafne bone cavity : a retrospective study of 11 cases(2006) Quesada Gómez, Carmen; Valmaseda Castellón, E.; Berini Aytés, Leonardo; Gay Escoda, CosmeObjective: to describe the clinical and radiological characteristics of patients with Stafne bone cavity. Study design: a retrospective, observational study of 11 cases of Stafne bone cavity. After finding an imagine compatible with Stafne bone cavity in the Orthopantomograph® of 11 patients, a sialography of the mandibular gland was made in 3 cases, computerized tomography (CT) in 6 cases, and in 4 cases surgical intervention to confirm the diagnosis. Results: the average age was 51.5 years, predominantly males. The entity was diagnosed incidentally during a routine radiology in all cases. The sialography revealed glandular tissue within the defect, and the CT demonstrated the conservation of the lingual cortical and the peripheral origin of the lesion. Glandular tissue was found within the lesions of two of the patients who underwent surgery, and in the other two the cavity was empty. No progressive changes were found in any of the 11 cases. Conclusions: Stafne bone cavity was an incidental finding, presenting no evolutionary changes, and as such conservatory therapy based on periodic controls was indicated. Currently, complementary techniques such as CT are sufficient to establish a certain diagnosis.
- Removal torque and physico-chemical characteristics of dental implants etched with hydrofluoric and nitric acid : an experimental study in Beagle dogs(2006) Martínez González, José María; García Sabán, Francisco; Ferrándiz Bernal, Javier; Gonzalo Lafuente, Juan Carlos; Cano Sánchez, Jorge; Barona Dorado, CristinaObjective: To study the composition, surface characteristics and response to removal torque of an implant surface subjected to hydrofluoric acid etching and posterior passivating with hydrofluoric and nitric acid. Study design: Twelve implants were initially selected and their physico-chemical characteristics were evaluated by means of energy-dispersive X-rays (EDS), scanning electron microscopy (SEM) and photoelectron spectroscopy (XPS). In addition, 24 implants ? 12 measuring 8 mm and 12 measuring 10 mm in length ? were implanted in 6 Beagle dogs. Twelve implants were removed after a recovery period of 6 weeks, followed by removal of the remaining 12 implants after 12 weeks, using a torque calibrator (Gauge Tonichi® model BGT150CN-S) with a force registry range of 0-150 Ncm. Results: EDS analysis of the surface chemical composition only revealed the presence of titanium in the etched surfaces. In the same way as with the surfaces of other dental implants, XPS analysis revealed traces of other elements present in the surface, fundamentally carbon. Following dual acid etching, the surface showed the roughness resulting from acid action, with a morphology that proved to be quite homogeneous. The roughness values obtained exceeded 1 µm. The mean removal torque values after 6 weeks were 79.7 Ncm for the 8 mm implants and 115 Ncm for the 10 mm implants. After 12 weeks, these values increased to 101.2 Ncm and 139.7 Ncm, respectively. Conclusions: Hydrofluoric and nitric acid etching affords optimum surface characteristics comparable to those of other surfaces. The recorded removal torque values raise the possibility of human clinical application for early or immediate loading procedures.
- A case report of coexistence of a sialolith and an adenoid cystic carcinoma in the submandibular gland(2006) Batzakakis, Dimitrios; Apostolopoulos, Kostas; Bardanis, IoannisÔhe occurrence of sialoliths in the submandibular gland is 80% due to the specific anatomy of both the gland and its duct. The diagnosis is rather easy because of the obvious clinical signs of the entity. Imaging studies are always necessary in order to treat the patient as effectively as possible. The stones do not tend to occur within the gland as frequently as in the respective duct. The coexistence of sialoliths and malignant tumors is extremely rare. A 70-year-old woman with intraparenchymal stone was operated in our ENT department. In addition to the sialolith the pathological examination revealed the existence of an adenoid cystic carcinoma (ACC), that extended to the neighboring skeletal muscle. This is the reason why we believe it would be useful to report this case of a large stone (14 mm in diameter) located in the submandibular gland coexisting with ACC. This case report is a very good example illustrating that all available means should be used prior to reaching a conclusion and making a health professional decision.
- Resonance frequency analysis after the placement of 133 dental implants(2006) Boronat López, Araceli; Peñarrocha Diago, Miguel; Martínez Cortissoz, Orlando; Mínguez Martínez, IgnacioIntroduction: The primary stability of dental implants is related to the bone in contact with the latter, and can be evaluated by resonance frequency analysis. Material and methods: Measurements were made in 133 implants (62 in the upper jaw and 71 in the mandible) of resonance frequency and insertion force to determine implant stability on the day of surgery, with an evaluation of its relationship to different variables. Results: The stability quotient of the implants on the day of surgery was 62.1, with an insertion force of 35.7 N. The insertion force was proportional to the resonance frequency, with an increasing stability quotient with growing insertion force. The stability quotient was greater in the larger diameter implants, shorter implants, in mandibular placement and in areas of more compact bone. Conclusions: The stability quotient on the day of implant placement is greater in higher bone density areas.
- Analysis of the use of expansion osteotomes for the creation of implant beds : Technical contributions and review of the literature(2006) Rambla Ferrer, Javier; Peñarrocha Diago, Miguel; Guarinos Carbó, JuanLa atrofia ósea severa del maxilar superior compromete e incluso, en ocasiones, impide la colocación de implantes. Con la expansión ósea mediante osteodilatadores se evita usar instrumentos rotatorios, no se produce calor ni se elimina hueso y se simplifica el tratamiento quirúrgico permitiendo la colocación de fijaciones sin recurrir a tratamientos más complejos. Presentamos una revisión de la técnica de expansión maxilar mediante osteodilatadores, describiendo las principales indicaciones, ventajas e inconvenientes de este procediminiento quirúrgico.
- Panoramic radiograph as a method for detecting calcified atheroma plaques : Review of literature(2006) Roldán Chicano, Rocío; Oñate Sánchez, Ricardo Elías; López Castaño, Fuensanta; Cabrerizo Merino, María del Carmen; Martínez López, FedericoLos accidentes cerebrovasculares (ACV) constituyen la tercera causa de muerte en los países industrializados, tras la cardiopatía isquémica y el cáncer. Se trata pues de un importante problema de Salud pública, no sólo por su elevada incidencia, sino también por el alto costo que genera la rehabilitación física y psicológica de estos pacientes. El Odontoestomatólogo, como profesional de la salud, debe implicarse ante esta situación y contribuir, dentro de sus posibilidades, a la detección precoz de los pacientes con riesgo de sufrir un ACV. Desde la década de los ochenta, distintos autores han descrito la posibilidad de detectar las placas de ateroma calcificadas localizadas en la bifurcación de la arteria carótida a través de la ortopantomografía (OPG). De este modo, las posibilidades del Odontoestomatólogo en este campo han sido ampliadas. Esta nueva aplicación de la OPG, sin embargo, debe superar ciertos obstáculos antes de poder afianzarse como una nueva medida de cribaje de pacientes con riesgo de sufrir un ACV. Entre éstos estaría, por una parte, la valoración del auténtico significado clínico, a nivel pronóstico, de la calcificación de las placas de ateroma al igual que su utilidad como factor predictor de aparición de cuadros de ACV y por otra, el realizar un correcto diagnóstico diferencial con otras estructuras calcificadas que pueden aparecer en la ortopantomografía.
- Dental caries in type 1 diabetics : influence of systemic factors of the disease upon the development of dental caries(2006) Miralles Jordá, Lucía; Silvestre Donat, Francisco Javier; Hernández Mijares, Antonio; Bautista, Daniel; Llambés Arenas, Fernando; Grau García-Moreno, DianaObjectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O?Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population.
- Expression of ?-catenin in carcinoma in pleomorphic adenoma, pleomorphic adenoma and normal salivary gland : An immunohistochemical study(2006) Prado, Renata Falchete do; Consolaro, Alberto; Taveira, Luís Antônio de AssisObjetives. Pleomorphic adenomas are the most frequent type of epithelial salivary gland neoplasms, and their malignant counterpart, the carcinoma in pleomorphic adenomas, is much less common. ?-catenin is a cell adhesion molecule associated with the invasion and metastasis of carcinomas of the head and neck, esophagus. The objective of this study was to detect the expression of ?-catenin in pleomorphic adenomas, carcinomas in pleomorphic adenomas and normal salivary glands to discuss its role in the development of these two lesions. Study Design. The expression of ?-catenin (BD Transduction Laboratories) was analyzed by immunohistochemistry in formalin-fixed, paraffin embedded specimens by the avidin-biotin-peroxidase complex method in 16 pleomorphic adenomas (12 from minor salivary glands), 3 carcinomas in pleomorphic adenomas (all from palate) and 10 normal salivary glands as control group (5 from major and 5 from minor salivary glands). Results. All cases of glands, adenomas and carcinomas in pleomorphic adenomas have membranous and cytoplasmic immunostaining. Nuclear ?-catenin immunostaining was not observed. The antibody presented a fine granular arrangement in the cytoplasm and cellular membrane of duct and acinic cells. Higher ?-catenin index rates were seen mainly in salivary gland ducts and in ductal structures in the adenomas and carcinomas in pleomorphic adenomas. There was protein loss in pleomorphic adenomas and cytoplasmic accumulation in carcinoma in pleomorphic adenomas. Conclusions. The present study showed participation of the loss of ?-catenin adhesion molecule in the development of pleomorphic adenoma, and that the cytoplasmic accumulation of the molecule takes part in the malignant transformation of the pleomorphic adenoma into carcinoma in pleomorphic adenoma.
- Oral burning symptoms and burning mouth syndrome-significance of different variables in 150 patients(2006) Brailo, Vlaho; Vucicevic Boras, Vanja; Alajbeg, Iva Z; Lukenda, Josip; Eurkoviæ, MarkoObjectives: Despite the extensive amount of published literature upon burning symptoms in patients with clinically healthy appearance of the oral mucosa, as well as burning mouth syndrome (BMS) itself, they both remain still challenging topics. The aim of this study was to determine the real prevalence of ?true? BMS in comparison to other patients with burning symptoms with clinically healthy appearance of the oral mucosa and then to compare ?true? BMS patients with healthy controls regarding gastritis and intake of anxiolytics and angiotensin converting enzyme inhibitors. Study design: In 150 patients with burning symptoms of clinically healthy oral mucosa, local and systemic investigations were performed and they included detection of candidal infection, salivary flow rate, presence of oral galvanism and parafunctional habits as well as complete blood count, serum ferritin, serum glucose levels, serum antibodies to Helicobacter pylori together with detailed medical history with special regard to medication intake. After ?true? BMS patients were identified they have been compared to the controls with regard to the presence of gastritis and the intake of anxiolytics and angiotensin converting enzyme inhibitors. Results: Our results show that gastritis were significantly more present among ?true? BMS patients and that they also significantly more intake anxiolitics, when compared to the control group. Conclusions: Our findings might lead to the conclusion that every ?true? BMS patient should be referred to the gastroenterologist and psychiatrist.
- Fibrosarcoma originating in the mandible(2006) Soares, Andresa Borges; Henrique Souza Lins, Lauro; Macedo, Adriana Parizzoto; Pereira Neto, João Sarmento; Vargas, Pablo AgustínFibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the oral cavity and can cause local recurrences or metastasis. In this article we describe a case of primary fibrosarcoma in the mandible in a 16-year-old girl. Microscopically the tumor showed an intense proliferation of spindle-shaped cells, varying little in size and shape and arranged in parallel bands, partly crossing each other, the mitotic activity was increased and there was nuclear pleomorphism. Immunohistochemically the cells only showed immunoreactivity for vimentin and negativity for S-100 protein, CD 68, cytokeratin cocktail, HMB-45, CD34, pan actin HHF 35, desmin, smooth muscle actin and epithelial membrane antigen (EMA). Based on clinical, radiological, histological and immunohistochemical findings the final diagnosis was high-grade intra-osseous fibrosarcoma. The treatment choice was radical surgery with mandibular reconstruction. After one year and nine months of the treatment the patient displayed multiple metastases. Radiation therapy and chemotherapy were used as adjuvant treatment. Unfortunately, the girl died two years after initial diagnosis.
- Palatine perforation induced by cocaine(2006) Padilla Rosas, Miguel; Jiménez Santos, Cecilia Irene; García González, Claudia LorenaEl consumo de cocaína va en aumento en la población mundial, los efectos del consumo de esta droga pueden ocasionar efectos secundarios. Se presenta un caso de paciente femenino de 48 años de edad que presenta una úlcera crónica buco-nasal de 2 meses de evolución, la cual le ocasiona problemas para la deglución y fonación.
- Cockayne?s Syndrome : A case report. Literature review(2006) Arenas Sordo, María de la Luz; Hernández Zamora, Edgar; Montoya Pérez, Luis A.; Aldape Barrios, B.El Síndrome de Cockayne (CS) es un desorden genético con un patrón de herencia autosómico recesivo que fue descrito por primera vez en 1936 por Cockayne. Los pacientes con este síndrome presentan detención del crecimiento, talla baja, envejecimiento prematuro, anormalidades neurológicas, fotosensibilidad, retraso en la erupción de los dientes primarios, ausencia congénita de dientes permanentes, macrodoncia parcial, atrofia de los procesos alveolares y caries dental. Puede ser causado por mutación en dos genes, el CKN1 (ERCC8) y el ERCC6, localizados en los cromosomas 5 y 10 respectivamente; originando dos tipos: CS-A que tienen mutación en ERCC8 y CS-B con mutación en ERCC6, este último provoca sensibilidad a la luz ultravioleta, secundaria a una deficiencia en la reparación de DNA. También se ha asociado el síndrome a mutaciones de los genes XPB, XPD y XPG. En el presente reporte se informa de un paciente de 9 años con cuatro meses de edad. En la exploración física se registró talla de 94 cm, peso de 8.6 kg y perímetro cefálico de 42 cm. TA 120/80. Hábito caquéctico, problemas posturales con encorvamiento, así como microcefalia, cara ovalada, ojos hundidos, nariz delgada y afilada, falta de grasa en la cara, más notorio en el tercio medio y orejas grandes que le confieren una apariencia de ?pajarito?. Se observa marcada fotosensibilidad en toda la piel expuesta al sol. Presenta retraso psicomotor y mental. Intrabucalmente se aprecia higiene deficiente, gingivitis, caries cervical, hipoplasia del esmalte, mala posición dentaria de los incisivos laterales superiores e inferiores, y macrodoncia de los dientes centrales superiores, el izquierdo presenta una lesión por caries. Radiográficamente se observa ausencia congénita de los dientes 14, 23, 24 e hipoplasia mandibular. El objetivo de este trabajo es dar a conocer a la comunidad odontológica las características del síndrome de Cockayne a través de un caso clínico.
- Oral cancer mortality in the province of Cordoba, Argentine Republic in the period 1975-2000 : A comparative study with other populations(2006) Morelatto, Rosana; López de Blanc, Silvia AdrianaMalignant neoplasm (MN) mortality worldwide ranks among the first four causes of death, in the 1990 decade (1-4). The aim of this work is to study the eight most frequent MN mortality rates, and especially that one caused by oral cancer (OC) in the province of Cordoba, Argentine Republic, in the period between 1975 and 2000, in order to analyze its characteristics and compare with other populations in America and Europe. Material and Methods: The data were provided by the provincial and national Health Ministry and Globocan 2000. Results: The highest male rates were those of Slovakia and France, prevailing lung and bronchus tumors; whereas in females the highest rate was that of breast cancer in the United Kingdom and Germany, and lung cancer in the United States. Regarding to OC in the populations under study, Slovakia and France held the highest rates for both sexes, being Cordoba and Argentina among the lowest values, especially in women. Tongue was the most frequent site in Cordoba (43.5%), followed by salivary glands (23.7%). Male prevailed over female and the oldest ages were observed in the period 1995-2000. The mortality rates by MN in all sites increased 6.6% in both sexes, and by OC 77% in women within the period under study in Cordoba. Oral cancer is a serious problem for public health causing great morbidity and mortality, a situation that has not improved in decades. Mortality rates are an important tool towards implementation and planning of health policies and programs for cancer prevention.
- Brachytherapy in lip cancer(2006) Rovirosa Casino, Angeles; Planas Toledano, Isabel; Ferre Jorge, Jorge; Oliva Díez, José María; Conill Llobet, Carlos; Arenas, MeritxellLip cancer is one of the most prevalent skin tumours of the head and neck. The characteristics of the tumour relate to their exophyitic growth in an area of easy visual acces which allows their diagnosis in early stages. As a result, there is a better prognosis with the present treatments. In early stages the treatment can be performed by surgery or by brachytherapy, and the results are similar on local control; nevertheless brachytherapy offers the best functional and esthetic results. We are reporting on a review of the literature in relation to indications, techniques and results of brachytherapy for lip cancer


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