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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2007. Vol. 12, no. 7
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- Factors related to survival from oral cancer in an Andalusian population sample (Spain)(2007) Vallecillo Capilla, Manuel Francisco; Romero Olid, María Nuria; Olmedo Gaya, María Victoria; Reyes Botella, Candela; Bustos Ruíz, VicenteIntroduction: Approximately 3% of malignant tumors originate in the oral cavity. The majority are squamous cell carcinomas, and a small percentage, malignant tumors of the salivary glands, lymphoreticular diseases, bone tumors, melanomas, sarcomas, malignant odontogenic tumors and metastases of tumors from other locations. The prognosis of these pathologies depends on the size, infiltration, and site of the lesion, the presence or absence of metastatic spread, and to a certain degree the differentiation of the tumor. The prognosis of an oral cancer remains generally negative, with 5-year survival figures below 50%, producing high rates of mortality and morbidity. Objectives: To evaluate the influence of different variables on survival in an oral cancer population. Patients and methods: Two-hundred and sixteen patients with oral squamous cell carcinoma were studied over a period of five years, evaluating 42 variables grouped into five data sections: personal, lesion, site, stage, and risk factors. Results and conclusions: Average survival was 2088 days, with a standard deviation of 98 days. The factors most associated with mortality were: location in the gingiva (p=0.0590), in the trigone (p=0.0104), size (T3-T4) (p=0.0004) and lymph node involvement (N2a-N2b) (p=0.0035). Tobacco and alcohol, nowadays considered to be highly significant in carcinogenesis, had no considerable influence on survival.
- The influence of soft acidic drinks in exposing dentinal tubules after non-surgical periodontal treatment: : a SEM investigation on the protective effects of oxalate-containing phytocomplex(2007) Sauro, Salvatore; Mannocchi, Francesco; Watson, Timothy F.; Pimontese, Matteo; Sherriff, Martyn; Mongiorgi, RomanoObjective: The aim of this study was to investigate the different smear layer morphologies produced by instrumentation with a hand curette and a periodontal sonic scaler for potential removal by soft acidic solution. The effect of a new oxalate-containing phytocomplex spray in preventing tubules exposure after citric acid solution application was also evaluated. Methods: Thirty recently extracted human teeth were used to obtain root dentinal fragments and divided in two groups: Curette treatment (CRT) root planed applying 30 working strokes to each surface using a Gracey?s curette 5-6 and Ultrasonic scaler (USC) treated using a periodontal scaler mounted on an ultrasonic hand-piece for 30 seconds. Each principal group was further divided in three sub-groups (Control, Acid challenge and Acid/Phyto-oxalate). The control group samples were immersed in distilled water buffered to pH 7.4 using NH4 OH solution. The samples of the acid challenge group were immersed in a solution of citric acid 0,02M; [pH 2.5] for 3 minutes. The samples of the Acid/Phyto-oxalate group were sprayed for 15 sec with a 1.5% phytocomplex spray prior to immersion. Samples were examined using SEM. Results: Ultrasonic instrumentation created a very thin smear layer whereas curettes produced a multilayered smear layer. The acidic solution was able to remove the smear layer from root surfaces treated with ultrasonic instrumentation exposing the dentinal tubules. The smear layer on the root surfaces treated with hand instruments was not completely removed. The phytocomplex solution was able to prevent dentinal tubule exposure. Conclusions: Acidic soft drinks are able to remove the smear layer created on root surfaces during different non-surgical periodontally treatments. The smear plugs created by hand instrumentation appeared to be more resistant to acid attack. The tested phytocomplex solution protected the dentine from demineralization and it might prevent post-treatment dentinal hypersensitivity induced by acidic soft drinks.
- Salivary gland application of botulinum toxin for the treatment of sialorrhea(2007) Fuster Torres, Mª Ángeles; Berini Aytés, Leonardo; Gay Escoda, CosmeSialorrhea or excessive salivation, and drooling, are common and disabling manifestations in different neurological disorders. A review is made of the literature, based on a PubMed search, selecting those articles describing clinical trials involving the injection of botulinum toxin A in the salivary glands of patients with different diseases characterized by sialorrhea. The most frequently treated diseases were infant cerebral palsy (30%), Parkinson?s disease (20%) and amyotrophic lateral sclerosis (15%). Over half of the authors injected the product into the parotid glands, 9.5% into the submaxillary glands, and 38% into both. The total doses of toxin injected varied from 10-100 units of Botox® or 30-450 units of Dysport® according to the different authors. A reduction was observed in the production of saliva following these injections, and the duration of the therapeutic effect was 1.5-6 months. Six articles (30%) described the presence of adverse effects such as dysphagia, xerostomia and chewing difficulties. Most of the clinical studies involved small patient samples, with no blinding or randomization, and no control group. Moreover, no data are available on the efficacy and adverse effects of treatment in the context of long-term prospective studies. The effective therapeutic dose and ideal form of application remain to be established, and require the conduction of further controlled clinical trials involving large sample sizes.
- Maxillary sinus lift with intraoral autologous bone and B ? Tricalcium Phosphate : histological and histomorphometric clinical study(2007) Aguirre Zorzano, Luis Antonio; Rodríguez Tojo, María José; Aguirre Urízar, José ManuelIntroduction: Rehabilitation with implants in the upper maxilla often implies a challenge due to the shortage and quality of the remaining bone. Different kinds of grafts have been described in an endeavour to solve these problems. Aim: The purpose of this study was to assess the osteoconduction potential of an autogenous bone and B-Tricalcium Phosphate mixture, in the treatment of atrophic upper maxillae. Materials and Methods: 22 patients were treated using the ?sinus lift? technique. All patients had residual bone equal to or greater than 5 mm, the sinus was lifted, bone grafted and implants installed during the same surgical procedure (autologous bone and B- Tricalcium Phospahate). During the implant exposure after the osseointegration period, samples of regenerated bone were taken using a trephine from 5 patients. Paraffin-embedded sections were analysed the structure and tissues percentages. Data were estimated statistically. Results: Clinical results showed integration of the 42 fixtures installed. Histological analysis showed good integration of the B-Tricalcium Phosphate in the newly formed bone likewise absence of inflammation. Histomorphometric analysis showed a mean bone proportion of 30.7% (range 22.8% ? 50.6%). Conclusions: Results suggest the osteoconductive material B-Tricalcium Phosphate associated with autologous bone obtained through filtration is an appropriate graft for implant treatment of atrophic maxillae, in combination with the sinus lift procedure.
- Oral biopsy in dental practice(2007) Mota Ramírez, Amparo; Silvestre Donat, Francisco Javier; Simo Ruiz, Juan ManuelThe conclusions drawn from the study of an oral biopsy are considered essential for the definitive diagnosis of diseases of the oral mucosa, and for the subsequent planning of appropriate treatment. Although the obtainment of biopsies is widely used in all medical fields, the practice is not so widespread in dental practice - fundamentally because of a lack of awareness of the procedure among dental professionals. In this context, it must be taken into account that the early diagnosis of invasive oral malignancy may be critical for improving the patient prognosis. However, in some cases the results are adversely affected by incorrect manipulation of the biopsy material. The present study provides an update on the different biopsy sampling techniques and their application. Such familiarization in turn will contribute to knowledge of the material and instruments required for correct biopsy performance in dentistry, as well as of the material required for correct sample storage and transport.
- Sinus elevation by in situ utilization of bone scrapers : technique and results(2007) Martos, Pedro L.; Naval Gias, Luis; Sastre Pérez, Jesús; González García, R.; Bances del Castillo, Fernando; Mancha de la Plata, María; Galindo Moreno, Pablo; Muñoz Guerra, Mario F.Objectives: The objective was to present a novel technique for antrostomy performed before sinus elevation in atrophic maxilla for subsequent implant placement. Material and methods: The study included 10 sinus elevations performed by the proposed technique in nine consecutive patients presenting with inadequate posterior maxillary height. The technique is described, calculating the antrostomy surface area, volume of bone tissue obtained and final height attained in each case. A total of 16 implants were placed. Results: All ten elevations were accomplished. Mean antrostomy surface area was 0.55 mm2 , mean bone volume obtained was 0.56 cm3 and mean height attained was 11.7 mm from a baseline mean height of 5.6 mm. Out of the 16 implants, 14 were inserted immediately after the elevation and 2 were inserted in a second step, after ossification; 93.7% of the implants were osseointegrated at 6 months after prosthesis placement. Conclusion: The use of bone scrapers to create antrostomy for sinus elevation is a simple and very safe procedure. It provides a variable amount of particulate bone graft that is easily handled and highly useful for packing the cavity that will elevate the sinus membrane.
- Effectiveness of low flow vascular lesions sclerosis with monoetanolamine : report of six cases(2007) Bonan, Paulo Rogério Ferreti; de Paula Miranda, Leonardo; Mendes, Danilo Cangussu; De Paula, Alfredo Maurício Batista; Pego, Sabina Pena Borges; Martelli Júnior, HercílioVascular malformations or even hemangiomas need therapeutic intervention if they start to cause clinical symptoms or personal discomfort. Different therapeutic modalities, including cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgery, and/or embolization, can be performed successfully. Sclerotherapy with monoethanolamine is a relatively simple and effective method to treat low flow vascular lesions. We presented a report of six cases of vascular malformations treated with monoethanolamine. There were 3 male and 3 female patients, with an age range of 20 to 68 years. The patients were submitted to applications according to clinical response and/or tolerability. In all cases, low-flow vascular lesions were recorded and submitted to infiltration with 2.5% monoethanolamine, directly into the lesions. The volume applied was approximately the middle of affected area. Vascular lesions were characterized as low-flow due to absence of arterial pulsation and flat consistence. The sclerosis with 2.5% monoethanolamine resulted in complete or partial involution, without severe complications.
- Distraction osteogenesis in Goldenhar Syndrome : case report and 8-year follow-up(2007) de Lima, Marina de Deus Moura; Marques, Yonara Maria Freire Soares; Alves Júnior, Sérgio de Melo; Ortega, Karem Lopez; Soares, Marcelo Melo; Magalhaes, Marina H.C.G.Goldenhar syndrome is a well-known condition featuring the following triad of anomalies: ocular abnormalities, microtia and vertebral anomalies. This syndrome involves structures arising from the first and second branchial arches. Craniofacial anomalies, including mandibular, zygomatic and/or maxillary hypoplasias are found in 50% of patients with Goldenhar syndrome. Patients with this syndrome may present unilateral or bilateral underdevelopment of the mandible. Several treatments for the correction of the dento-facial deformity have been described, among them distraction osteogenesis is one that shows promising results. Distraction osteogenesis is the process of bone formation that occurs during slow separation of the segments of bone after an osteotomy and it has been used to alleviate facial asymmetry. Mandibular distraction osteogenesis has been applied for many years, but long-term reports present controversial results. The purpose of the case report is to describe the immediate and long-term effects of distraction osteogenesis used to treat mandible asymmetry in a 5-year-old boy with Goldenhar syndrome.
- Criteria for selecting children with special needs for dental treatment under general anaesthesia(2007) Nova García, Joaquín de; Gallardo López, Nuria Esther; Martin Sanjuan, Carmen; Mourelle Martínez, Mª Rosa; Alonso García, Yolanda; Carracedo Cabaleiro, E.Objective: To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. Materials and methods: Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children?s Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental treatment under general anaesthesia was given during 2005. Relevant data were taken from their case histories with regard to their general health, oral health and behaviour. Results: In most of the children (22 children), it was possible to carry out a complete dental diagnosis. With regard to medical diagnoses, the most frequent pathology was cerebral palsy (8 children), but it was not possible to establish a link between the pathology and the use of general anaesthesia. With regard to oral health, most of the children received restorative treatment in all 4 quadrants (26 children). On the basis of scales for behavioural evaluation and movement, most of the children (17 children) showed clearly negative behaviour, with movements that interrupted or hindered examination. Conclusions: With the exception of certain specific medical problems, the reasons for using general anaesthesia for dental treatment in children with special needs are extensive treatment needs and bad behaviour, both of which can be judged objectively.
- A histological and clinical study on oral cancer : descriptive analyses of 365 cases(2007) Dias, Gonçalo Seguro; Almeida, Arlindo PereiraCancer is the second cause of death in Portugal right after cardio vascular diseases. In Portugal the incidence of oral and pharynx cancer (OPC) is higher than uterus and larynx cancers, and in US its frequency is higher than melanoma or uterus cancer, diseases that concern more population than oral cancer. Aims The aim of this paper is to identify preferable anatomic location for oral cancer, mean age of patients, the use of tobacco and alcohol, histological characteristics, staging, type of therapeutics, presence of metastases and 1 and 5 year follow up. Matherials and Methods Data was collected from clinical charts of 365 cases from the Centro de Lisboa do Instituto Português de Oncologia with histological confirmation of malign tumor of the mouth. These cases are the total of oral malign tumors in the years of 1997, 1998 and 1999 in that institution. Results We observe that despite modern diagnostic and treatment techniques 37,9% of all patients died after first year with evidence of tumor. From all patients just 23,7% were free of disease after 5 years of treatment. Tongue was the principal region affected and the average age was 62, 25 years. It was concluded that 57, 8% of patient were smokers and 43,8% were alcohol drinkers. A high number of patients were submitted to radiotherapy either alone or with other treatment options.
- Oral non-squamous malignant tumors; diagnosis and treatment(2007) Waal, Rutger van der; Waal, Isaäc Van derSome 90% of oral cancers consist of squamous cell carcinomas that arise from the oral mucosa. The remaining 10% of malignancies consist of malignant melanomas, carcinomas of the intraoral salivary glands, sarcomas of the soft tissues and the bones, malignant odontogenic tumors, non-Hodgkin?s lymphomas and metastases from primary tumors located elsewhere in the body. These malignancies will be briefly reviewed and discussed. The emphasis is on diagnosis and management.
- Lymphoid lesions of salivary glands : malignant and Benign(2007) Ellis, Gary L.Lesions of salivary glands with a prominent lymphoid component are a heterogeneous group of diseases that include benign reactive lesions and malignant neoplasms. Occasionally, these pathologic entities present difficulties in the clinical and pathological diagnosis and prognosis. Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, and extranodal marginal zone B-cell lymphoma are examples of this pathology that are sometimes problematic to differentiate from one another. In this paper the author reviewed the main clinical, pathological and prognostic features of these lesions.
- Results of a dental care protocol for mentally handicapped patients set in a primary health care area in Spain(2007) Escribano Hernández, Alfonso; Hernández, Tomás; Ruiz Martín, Eduardo; Porteros Sánchez, Jose AndrésObjective: Disabled people have the same right as other people to receive the health care they need, but they sometimes have difficulties to achieve it. In Castilla y Leon it has come into effect a law to guarantee Primary and Secondary Care coordination to provide dental treatment under sedation or anaesthesia to mentally disabled people who need it. Our aim is to evaluate the results of the implementation of such a law through a specific protocol in our health setting. Study design: Descriptive, made in a Health Area over a year, on mentally disabled people who were sent to hospital for treatment under anaesthesia after Primary Dental Care Units assessment. It has been studied the age, gender, mental disease, dental diagnosis and treatment undergone. Results: 108 patients attended the program (51% male), with a mean age of 31 years. 67% presented profound learning disability, 19% mental illness with disability, 11% presented cerebral palsy and another 3% had autism. Most frequent dental pathologies were caries (86%) and dental plaque (71%). Most common dental procedures were tooth extraction (78%), professional tooth cleaning (75%) and fillings (67%). Conclusions: We achieved to provide necessary dental treatment to a large number of disabled people, who would not have received it otherwise. It was a challenge to plan and implement the protocol coordinating Health Care Levels and workers. It still has to be done an economic and efficiency analysis of procedures and a patient satisfaction study.
- Time elapsed between the first symptoms, diagnosis and treatment of oral cancer patients in Belo Horizonte, Brazil(2007) Abdo, Evandro Neves; Garrocho, Arnaldo de Almeida; Barbosa, Alvimar Afonso; Oliveira, Enaldo Lopes; França Filho, Lyzio; Negri, Sérgio Luiz Coelho; Pordeus, Isabela AlmeidaObjective: One of the most important objectives of a public health service is early diagnosis of disease, which provides a better prognosis and reduction in treatment cost. We investigated the delay for diagnosis and treatment of oral cancer in a public hospital. Material and methods: One hundred eighty records of patients who attended for their first consultation in the department of head and neck surgery in a public hospital from Belo Horizonte?Brazil, between the period from 1 January 1999 to 31 December 2001 were analysed. The following variables were analyzed: gender, age, evolution time (ET), time elapsed from referral to hospital and first appointment (RT), time elapsed from first appointment and treatment (TT), total time elapsed from first noticing the lesion and starting treatment (TTE), sites and staging. Results: Results for males and females were, respectively: mean age = 57.9 and 60.8 years; ET= 169.4 and 215.4 days; RT = 27.9 and 40.6 days; TT = 40.9 and 44.9days; TTE = 207.9 and 263.8 days. No correlation was observed between age and TTE for either gender. Women presented the highest mean values for ET and TTE (p<0.01). Conclusion: It was concluded that public health policy should be developed to address the excessively long time lapsed between diagnosis and treatment as well as improve public health education programs to promote early oral cancer identification.
