Investigation into the association between physical health parameters and tongue image characteristics in college students

Objective: To investigate the correlation between physical health and tongue signs in college students. Methods. Twelve hundred and fourteen college students in the first year of a university in Ningbo were randomly selected as the study subjects, all of whom met the inclusion criteria to test their physical health and perform Chinese medicine tongue diagnosis. All collected data were later imported into an Excel sheet to create a database, and SPSS19.0 statistical software was used for data statistics and analysis. The mean of the measured data was expressed as standard deviation ±, the count data was expressed as frequency, the categorical data was expressed as X2 test, and the analysis was performed using binary logistic regression. Results. (1) Among each constitution type, the agreement rates from highest to lowest were: damp-heat constitution (85.17%), blood stasis constitution (83.33%), calm constitution (79.78%), yin deficiency constitution (75.68%), yang deficiency constitution (74.47%), phlegm-damp constitution (69.70%), qi deficiency constitution (65.00%), qi-yu constitution (0.00%), special endowment physique (0.00%). (2) The two factors of gender and obesity had a small effect on the agreement rate of the results of the tongue image and health status questionnaire in identifying TCM constitution, and the difference was not statistically significant (p>0.05). (3) Two factors, the degree of understanding of the health status questionnaire and the environment in which the tongue images were taken, had a greater influence on the agreement rate between the tongue images and the health status questionnaire in identifying the TCM physique, and the difference was statistically significant (p < 0.05). (4) Logistic regression analysis showed that lung capacity, sitting forward bend, 1000m, standing long jump for boys, 50m and 800m for girls were the influencing factors of normal tongue image (AU)

A surprising finding: The curious case of a tongue lesion misdiagnosed as paracoccidioidomycosis / Un hallazgo inesperado: el curioso caso de una lesión en la lengua diagnosticada erróneamente como paracoccidioidomicosis

Background: Paracoccidioidomycosis is an endemic mycosis caused by members of the Paracoccidioides genus. Brazil remains the focus area and, to a lesser extent, the disease has been reported from Argentina, Colombia and Venezuela. Aims: A Venezuelan Paracoccidioides brasiliensis strain, isolated from a patient diagnosed with chronic multifocal paracoccidioidomycosis, was subjected to whole genome sequencing to provide more insight about Paracoccidioides outside the endemic focus area. Methods: P. brasiliensis strain CBS 118890 was whole genome sequenced using nanopore; library preparation with the ‘native barcoding genomic DNA kit’ was followed by sequencing on Flongle and MinION flowcells. Batches of strain CBS 118890 were re-identified by sequencing the internal transcribed spacer (ITS) region, and final identification was made based on phylogenetic analysis. Results: Surprisingly, the Venezuelan P. brasiliensis strain CBS 118890 turned out to be a Nannizziopsis species. The batches of this strain were ITS sequenced followed by phylogenetic analysis and resulted in the final identification of Nannizziopsis arthrosporioides. Conclusions: Nannizziopsis infections are commonly seen in a wide variety of reptiles, but are particularly rare in human infections. This case underlines the need for molecular characterization of cases that clinically mimic paracoccidioidomycosis but that are serologically negative for Paracoccidioides.(AU)

Antecedentes: La paracoccidioidomicosis es una micosis endémica causada por especies del género Paracoccidioides. Brasil sigue siendo el área con la mayor incidencia y, en menor medida, se ha informado de casos en Argentina, Colombia y Venezuela. Objetivos: Una cepa venezolana de Paracoccidioidesbrasiliensis, obtenida de un paciente diagnosticado con paracoccidioidomicosis multifocal crónica, se sometió a secuenciación completa del genoma para obtener más información sobre Paracoccidioides fuera del área de foco endémico. Métodos: Se secuenció el genoma completo de la cepa CBS 118890 de P. brasiliensis mediante la técnica de secuenciación de nanoporos; tras la preparación de la librería con el «native barcoding genomic DNA kit» se procedió a la secuenciación con el Flongle y MinION flowcells. Los lotes de la cepa CBS 118890 se volvieron a identificar mediante la secuenciación de la región del espaciador transcrito interno (ITS), y la identificación final se realizó en función del análisis filogenético. Resultados: Sorprendentemente, la cepa venezolana P. brasiliensis CBS 118890 resultó ser una especie de Nannizziopsis. Los lotes de esta cepa se secuenciaron mediante ITS seguido de un análisis filogenético y dieron como resultado la identificación de la especie Nannizziopsis arthrosporioides. Conclusiones: Las infecciones por Nannizziopsis se observan comúnmente en una amplia variedad de reptiles, pero son particularmente raras en infecciones humanas. Este caso subraya la necesidad de la caracterización molecular de los casos que clínicamente reflejan paracoccidioidomicosis, pero que son serológicamente negativos para Paracoccidioides.(AU)

Epidermoid cyst of the tonge: two new cases of an extremely uncommon entity / Quiste epidermoide de la lengua: dos nuevos casos de una entidad extremadamente infrecuente

El quiste epidermoide (QE) es una lesión benigna que emerge como un aumento indoloro y fluctuante del volumen. Es una lesión rara en la cavidad oral y su diagnóstico a través de exámenes clínicos y radiografía convencional proporciona resultados limitados. Por lo tanto, el propósito del presente trabajo es reportar dos casos de lesiones raras de la lengua diagnosticadas como QE en dos pacientes adultos tratados quirúrgicamente. Un hombre de 65 años y una mujer de 40 años se quejaban de una “bolita” en la lengua. Los pacientes presentaron lesiones en la lengua en sitios anatómicos con distintas presentaciones clínicas. El tratamiento adoptado fue una resección de la lesión y, tras un análisis histopatológico, el diagnóstico final apuntó a un quiste epidermoide. En los casos actuales, la lesión ocurrió en el vientre y el dorso de la lengua, y ambos fueron tratados quirúrgicamente. Así, se convirtieron en los casos 14 y 15 de QE en lenguas encontradas en la literatura, confirmando así la relevancia del trabajo actual. (AU)

Epidermoid cyst (EC) is a benign lesion that emerges as a painless and fluctuating increase of volume. EC is a rare injury in the oral cavity and its diagnostic through clinical exams and conventional radiography provides limited results. Thus, the purpose of the current work is to report two cases of rare tongue lesions diagnosed as EC in two adult patients treated surgically. A 65-year old man and a 40-year old woman were complaining of a “little ball” in their tongue. The patients presented tongue lesions in anatomical sites with distinct clinical presentations. The adopted treatment was a resection of the lesion and, after a histopathological analysis, the final diagnostic pointed to an epidermoid cyst. In the current cases, the lesion occurred in the belly and dorsum of the tongue, and both were treated surgically. And so they became the 14th and 15th cases of EC in tongues found in the literature, thus confirming the relevance of the current work. (AU)

Safety of tongue base procedures for sleep apnoea in adults: A systematic review and metanalysis from the YO-IFOS study group

Objective: Tongue base and hypopharynx are the major sites of obstruction in OSA patients with failed palatal surgery. In recent years, several minimally invasive procedures have been developed to address tongue base obstruction. However, the research focus has consistently been on the effectiveness of surgery in reducing obstructive sleep apnoea rather than on postoperative complications. In this systematic review and metanalysis we aim to review the complication rate of minimally invasive base of tongue procedures for OSAS in adults.Data sourcesPubMed (Medline), the Cochrane Library, EMBASE, Scopus, SciELO and Trip Database.Review methodsData sources were checked by three authors of the YO-IFOS sleep apnoea study group. Three authors extracted the data. Main outcome was expressed as the complication rate and 95% confidence interval for each surgical technique.Results20 studies (542 patients) met the inclusion criteria. The mean complication rate is 12.79%; 4.65% for minor complications, 6.42% if they are moderate, and 1.77% if severe. The most reported complication overall is infection, in 1.95% of cases, followed by transient swallowing disorder, occurring in 1.30% of the total sample.ConclusionThe heterogeneity amongst the included studies prevents us from obtaining solid conclusions. The available evidence suggests that minimally invasive base of tongue procedures may present a wide spectrum of complication rates, ranging from 4.4% in tongue base radiofrequency to up to 42.42% in tongue base ablation. (AU)

Objetivo: La base de la lengua y la hipofaringe son los principales sitios de obstrucción en pacientes con AOS persistente tras una faringoplastia. En los últimos años se han desarrollado numerosas técnicas de cirugía mínimamente invasiva con el objetivo de tratar la obstrucción en este nivel. Sin embargo, el foco de los investigadores se ha situado habitualmente en la efectividad de la técnica para reducir el número de eventos obstructivos, más que en sus complicaciones. En esta revisión sistemática y metaanálisis se evalúa la incidencia de complicaciones de procedimientos mínimamente invasivos para la base de la lengua en pacientes adultos con AOS.Bases de datosPubMed (Medline), Cochrane Library, EMBASE, Scopus, SciELO y Trip Database.Método de revisiónLas bases de datos fueron evaluadas por 3 autores del grupo de investigación en apnea YO-IFOS. Tres autores extrajeron la información. Los resultados principales se expresaron como porcentaje de complicación e intervalo de confianza al 95% para cada técnica quirúrgica.ResultadosVeinte estudios (542 pacientes) cumplieron los criterios de inclusión. La incidencia media de complicaciones fue del 12,79%; un 4,65% fueron menores, un 6,42% moderadas y un 1,77% severas. La complicación más habitual fue infección en el 1,95% de los casos, seguida por alteración transitoria de la deglución en un 1,30%.ConclusiónLa heterogeneidad de los artículos incluidos no permite obtener conclusiones firmes. La evidencia disponible muestra que la cirugía mínimamente invasiva de la base de la lengua presenta un intervalo amplio de complicaciones que varía entre el 4,4% en la radiofrecuencia de la base de la lengua y el 42,42% en la ablación de la base de la lengua. (AU)

Massa lingual en un lactant: coristoma glial / Masa lingual en un lactante: coristoma glial / Tongue mass in an infant: glial choristoma

Introducció. Una massa lingual en un lactant és poc freqüent i l’etiologia és variada. Si no es diagnostica i tractaadientment de manera precoç, les conseqüències podenser molt greus, depenent de l’etiologia i la localització.Cas clínic. Lactant de 2 mesos amb una massa al dors dela llengua que permet la lactància materna i provoca unsoroll ronc. En explorar l’orofaringe, la massa de 2 x 1 cmes verticalitza i causa un ennuegament momentani del lactant. L’estudi anatomopatològic va confirmar el diagnòsticcom a coristoma glial de la llengua, i la cirurgia va ser resolutiva. Actualment, dos anys i mig després de la cirurgia,el pacient està lliure de malaltia.Comentaris. L’heterotòpia glial lingual és una entitat moltrara que pot comportar obstrucció de la via aèria i dificultats greus en la lactància. Difondre aquesta patologia permetrà als clínics diagnosticar-la abans, evitar greus situacions d’obstrucció de la via aèria, millorar el resultat ievitar traqueotomies. El tractament definitiu és quirúrgic.El maneig multidisciplinari és imprescindible per aconseguir bons resultats. (AU)

Introducción. Una masa lingual en un lactante es poco frecuente ysu etiología es variada. Si no se diagnostica y trata adecuadamentede manera precoz, las consecuencias pueden ser muy graves, según su etiología y su localización.Caso clínico. Lactante de 2 meses con una masa en el dorso de lalengua que permite la lactancia materna produciendo un ruidoronco. Al explorar la orofaringe, la masa de 2 x 1 cm se verticalizay causa el ahogamiento momentáneo del paciente. El estudio anatomopatológico confirmó el diagnóstico y la cirugía fue resolutiva.El resultado histológico concluye: coristoma glial de la lengua. Elpaciente está actualmente libre de enfermedad, a los dos años ymedio de la cirugía.Comentarios. La heterotopia lingual glial es una entidad muy raraque puede comportar obstrucción de la vía aérea y graves dificultades en la lactancia. Difundir esta entidad permitirá a los clínicos diagnosticarla antes, evitar situaciones graves de obstrucción de lavía aérea mejorando el resultado y evitando traqueotomías. El tratamiento definitivo es quirúrgico. El manejo multidisciplinar esimprescindible para conseguir buenos resultados, hecho que dainterés a esta entidad. (AU)

Introduction. A tongue mass is a very rare occurrence in infants,and its etiology is varied. If accurate diagnosis and treatment arenot achieved early, tongue masses can lead to severe complications depending on etiology and location.Case report. A 2-month-old infant presented with a mass on theback of the tongue that allowed breastfeeding but produced astrong stridor. The 2x1 cm mass become verticalized during exploration of the oropharynx, resulting on transient complete occlusionof the upper airway. A complete resection was performed, pathology showed a glial choristoma, and the child shows no evidenceof disease two and a half years after diagnosis.Comments. Glial heterotopia of the tongue is a rare entity that maycause severe airway obstruction and difficult breastfeeding. Recognition of this rare entity will allow clinicians to perform an earlydiagnosis, avoid severe situations of airway obstruction, avoid tracheostomies, and improve outcomes. The definitive treatment issurgery, and a multidisciplinary management is critical for optimaloutcomes. (AU)

Alveolar soft part sarcoma of the tongue. A case report of a rare entity / Sarcoma alveolar de partes blandas de la lengua. Informe de un caso de una entidad rara

Alveolar soft part sarcoma (ASPS) is a distinct soft tissue sarcoma among adolescent and young individuals. It accounts for 1 % of all sarcomas. It is a rare malignancy of the mesenchymal tissue that possesses an uncertain histologic origin. The increased vascular nature of this lesion leads to the dissemination of tumour cells through the connective tissue along the haematogenous route. Here we present a case of a swelling involving the tongue of a 19-year-old male patient and emphasize on the importance of diagnostic aids and management of this rare and unique lesion. (AU)

El sarcoma alveolar de partes blandas (ASPS, por sus siglas en inglés) es un sarcoma de partes blandas distinto entre los adolescentes y los jóvenes. Representa el 1 % de todos los sarcomas. Es una rara neoplasia maligna del tejido mesenquimatoso que posee un origen histológico incierto. El aumento de la vascularización de esta lesión conduce a la diseminación de células tumorales a través del tejido conjuntivo por vía hematógena. Aquí presentamos un caso de tumefacción en la lengua de un paciente masculino de 19 años y enfatizamos la importancia de las ayudas diagnósticas y el manejo de esta rara y única lesión. (AU)

Tumor miofibroblástico de lengua / Myofibroblastic tongue tumour

El tumor miofibroblástico inflamatorio (TMI) es un tumor del estroma submucoso raro cuya presentación más frecuente es en el pulmón. Se trata de un tumor heterogéneo, formado por células fusiformes, inflamatorias y miofibroblastos, que por lo general es benigno, pero puede producir invasión local, recidiva y transformación maligna. Presentamos un paciente joven con una neoplasia en la lengua de aspecto invasivo e infiltrante que resultó ser un tumor miofibroblástico, pero que causó gran preocupación por su rápido crecimiento.(AU)

An inflammatory myofibroblastic tumour is a rare submucosal stromal tumour whose most common presentation is in the lung. This is a heterogeneous tumour, comprised of spindle cells, inflammatory cells and myofibroblasts, which is generally benign. However, it can cause local invasion, recurrence and malignant transformation. We report a young patient with an invasive and infiltrating tumour on the tongue that turned out to be a myofibroblastic tumour but caused major concern due to its rapid growth.(AU)

Refranes que matan: hacia la concienciación social desde el aula / Raising social awareness in the classroom: Spanish proverbs that kill

Este trabajo surge de mi ponencia en el Congreso Anual de la Asociación de Lenguas Modernasde los Estados Unidos (MLA) el 9 de enero del 2019, en Chicago, Illinois. Aborda la función didácticade dichos y refranes como auténticas cápsulas culturales en el contexto del español médico,campo de primera necesidad en los Estados Unidos. El papel protagonístico de la lengua en lacultura (y viceversa) —condensado en máximas que hacen eco de una conciencia colectiva—, amenudo transmite altas dosis de machismo que, abierta o solapadamente, alimenta el engranajeinstitucionalizado de la violencia contra la mujer y contra el colectivo LGTBIQ+. Por ello, este breverecorrido por tonos disonantes nos hablará de creencias culturales opresivas que aún repercutenen la salud y en el bienestar de la mujer y de otras personas también históricamente vulneradas.El objetivo de esta experiencia de aprendizaje (mía y nuestra) es que la voz que escuchemosnos llame a examinar junto con nuestro alumnado ideas heredadas que —lejos de dar vida yesperanza— enferman y matan. Así posibilitaremos el cambio individual y social en pro de la salud y de los derechos humanos. (AU)

Part of this work was presented by the author on January 9, 2019, at the MLA (ModernLanguage Association) Annual Convention in Chicago, Illinois. It addresses the didactic role ofSpanish sayings and proverbs as authentic cultural capsules in the context of medical Spanish,a necessary field in the United States. The leading role of language in culture (and vice versa),synthesized within maxims echoing a collective consciousness, frequently conveys high levels ofsexism. It is male chauvinism that, openly or covertly, feeds the institutionalized mechanism ofviolence against women and against the LGBTQIA+ community. Thus, this short journey throughdissonant tones will talk to us about oppressive cultural beliefs that still impact women’s healthand the health of others whose rights have also been historically violated. The objective of thislearning experience (mine and yours) is that the voice that we hear will call us and our studentsto examine inherited ideas so remote from life and hope, that they sicken and kill. In so doing,we will be empowering individual and social change towards improved health and the defense of human rights. (AU)

Validación de la Escala de Eficacia Docente para la Escritura en el Contexto Educativo Español / Validation of the Teacher Efficacy Scale for Writing in the Spanish educational context

Este estudio se centra en adaptar y validar la escala Teacher Efficacy Scale for Writing al contexto educativo español. Participaron en el estudio 452 profesores de Lengua Castellana y Literatura de la Educación Obligatoria. Se analiza un modelo factorial de dicha escala constituido por 2 factores, eficacia general y eficacia personal, constituido este último por dos subfactores. Asimismo, se compara el ajuste factorial del modelo propuesto frente al modelo tradicional bidimensional y se analiza la invarianza de este en base al género y nivel educativo en el que imparten docencia los participantes. Los resultados obtenidos confirman un buen ajuste de los datos al modelo factorial propuesto y la invarianza factorial del mismo según las características de los participantes. Por tanto, la Escala de Eficacia Docente para la Escritura se puede considerar una herramienta de rápida aplicación, válida y fiable para determinar la eficacia docente hacia la escritura en el profesorado español.

In this study, we adapt and validate the Teacher Efficacy Scale for Writing to the Spanish educational context. The study participants comprised 452 teachers of Spanish language and literature from compulsory education. We analyse a factorial model of the scale with two factors, personal efficacy and general efficacy, and two sub-factors within the personal efficacy factor. We also compare the fit of the proposed factorial model to the traditional 2-factor model and analyse the factorial invariance of the model with respect to participants’ gender and educational level. Our results confirm that the proposed factorial model has a good fit to the data as well as its factorial invariance with respect to the sample characteristics. The Escala de Eficacia Docente para la Escritura is a valid, reliable, easy-to-use instrument for assessing teacher efficacy for writing in Spanish teachers.

Risk factors associated with tongue lesions: a propensity score-matched case-control study

Background: to analyse the potential risk factors of tongue lesions, comparing the results with a control group. Material and Methods: An observational, case-control study was designed. The study included a case group comprising 336 patients with tongue lesions and 336 sex and age-matched controls. We recorded tobacco/alcohol habits, presence of dentures, allergies, medical conditions, and medications. Statistical analysis was performed via logistic regression models to estimate the odds ratio (OR) adjusted for gender, age, tobacco, and alcohol using propensity score-matching analysis (PSM). Results: According to the final PSM model, patients with tongue lesions were more likely to suffer from allergies (OR 2.13; 1.27-3.66) or medical conditions (OR 2.14; 1.19-3.85), and more likely to take medication (OR 1.99; 1.11-3.57). Elderly individuals were more prone to hairy tongue (OR 3.82; 1.53-10.47). Smoking was associated with coated tongue (OR 2.05; 1.12-3.63), hairy tongue (OR 3.77; 1.52-9.22) and median rhomboid glossitis (OR 40.49; 5.84-860.43). Allergic individuals were more likely to exhibit sublingual varices (OR 1.73; 1.02-2.88). Medical conditions increased the chances of having coated tongue (OR 2.44; 1.36-4.64) or crenated tongue (OR 2.70; 1.42-5.30). Arterial hypertension was associated with median rhomboid glossitis (OR 5.85; 1.08-34.18). Individuals on medication showed a higher risk of fissured tongue (OR 1.87; 1.20-2.94) and varices (OR 2.42; 1.58-3.80). Agents acting on the alimentary tract and metabolism increased the probability of fissured tongue (OR 2.31; 1.42-3.79). Conclusions: As far as we are aware, this is the first study on lingual pathology to include a PSM analysis. The results suggest that a history of allergies, the presence of medical conditions, and the use of medication are associated with increased probability of tongue lesions. The analysis of diseases and medications by subgroups requires studies matched by habits with larger sample sizes, in order to corroborate our observations.(AU)

Tongue lesion due to Cryptococcus neoformans as the first finding in an HIV-positive patient / Lesión lingual por Cryptococcus neoformans como primer hallazgo clínico en una paciente VIH positiva

BACKGROUND: Cryptococcosis is a severe universally distributed mycosis which mainly affects immunocompromised hosts. This mycosis is caused by yeasts of two species complex of the genus Cryptococcus: Cryptococcus neoformans and Cryptococcus gattii. Meningeal cryptococcosis is the most frequent clinical presentation of this disseminated mycosis. The oral mucosa involvement is extremely unusual. CASE REPORT: We present a case of cryptococcosis with an unusual clinical form. The patient was assisted because she had an ulcerated lesion on the lingual mucosa. Encapsulated yeasts compatible with Cryptococcus were found in microscopic exams of wet preparations from lingual ulcer clinical samples obtained for cytodiagnosis and mycological studies. Cryptococcus neoformans (C. neoformans var. grubii VNI) was isolated in culture. This patient did not know her condition of HIV seropositive before the appearance of the tongue lesion. CONCLUSIONS: The involvement of the oral mucosa is uncommon in this fungal infection, but is important to include it in the differential diagnosis in HIV positive patients

ANTECEDENTES: La criptococosis es una micosis grave de distribución universal que afecta principalmente a los huéspedes inmunodeficientes. Se han definido dos complejos de especies patógenas: Cryptococcus neoformans y Cryptococcus gattii. La meningoencefalitis es la presentación clínica más frecuente de esta micosis sistémica. La afectación de la mucosa oral es extremadamente rara. CASO CLÍNICO: Presentamos el caso de una paciente VIH positiva con una forma clínica inusual de criptococosis. La enferma presentaba una lesión ulcerada en la punta de la lengua. El examen microscópico en fresco de la escarificación y de la biopsia de esta lesión mostraron levaduras capsuladas compatibles con Cryptococcus. Se obtuvo Cryptococcus neoformans (C. neoformans var. grubii VNI) en los cultivos. La paciente conoció su estado inmunológico (infección por VIH) en el contexto de esta enfermedad oportunista. CONCLUSIONES: La afectación de la mucosa oral es poco común en esta infección fúngica, pero es importante incluirla en el diagnóstico diferencial en pacientes VIH positivos

Carcinoma papilar en tiroides lingual. Una entidad inusual / Lingual thyroid papillary carcinoma. An unusual entity

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A novel mobile application to determine mandibular and tongue laterality discrimination in women with chronic temporomandibular disorder

BACKGROUND: Chronic pain from temporomandibular disorders (TMDs) is caused by a somatosensory disturbance due to sustained activation of central nervous system nociceptive pathways, which can induce changes in neuroplasticity in the thalamus, basal ganglia and limbic system, as well as disturbances in the somatosensory, prefrontal and orbitofrontal cortex and cognitive impairment. The main objective of this study was to determine the discrimination capacity of mandibular and tongue laterality between women with chronic TMDs and asymptomatic women. MATERIAL AND METHODS: This descriptive-comparative study examined 2 groups with a total of 30 women. All participants were between the ages of 23 and 66 years and were assigned to the chronic TMD group or the asymptomatic group according to the inclusion criteria. We employed a mobile application developed specifically for this study to measure the accuracy and reaction time (RT) of mandibular and tongue laterality discrimination. RESULTS: The chronic TMD group had a lower success rate in laterality discrimination (mean mandibular accuracy of 40% and mean tongue accuracy of 67%) than the asymptomatic group (mean mandibular accuracy of 61% and mean tongue accuracy of 90%). These results showed statistically significant differences between the groups for mandibular laterality discrimination (d, 1.14; p < 0.01) and tongue laterality discrimination (d, 0.79; p = 0.03). The asymptomatic group had faster RTs than the chronic TMD group. The data revealed statistically significant differences for the right mandibular RT (d, 0.89; p=0.02) and right tongue RT (d, 0.83; p = 0.03). However, there were no significant differences for left mandibular and left tongue RT. CONCLUSIONS: We found that the women with chronic TMDs had a lower success rate and slower RTs in the discrimination of mandibular laterality when compared with the asymptomatic women

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Effect of lingual-based flap design on postoperative pain of impacted mandibular third molar surgery: Split-mouth randomized clinical trial

BACKGROUND: The extraction of third molars is one of the most common procedures in oral and maxillofacial surgery clinic. Surgical extraction involves the manipulation of both soft and hard tissues, so the patient usually experiences pain, swelling, and trismus in the immediate post-operative period. Several studies have been conducted using different types of surgical flaps to provide access with the least possible damage of soft tissues. Designing and implementing an optimum flap, which provides easier technique, better visibility, minimal post-operative complications, and best healing, is an aspired goal of every oral surgeon. This study aimed to compare lingual-based four-cornered flap with conventional triangular flap, and to evaluate its effect on post-operative pain after surgical extraction of impacted lower third molars. MATERIAL AND METHODS: Seventeen patients (age ranged from 19 to 26 years) with bilateral, symmetrical impacted lower third molars (n=34) were included in the study. This was a randomized clinical trial with a split-mouth design. The impacted molars were assigned randomly, by coin flipping, to two groups: Case side with lingual-based four-cornered flap (Group A), and control side with conventional triangular flap (Group B). Away from the incision, the prognosis, surgical intervention, and postoperative procedures were exactly the same for the two groups. Postsurgical pain was assessed for 5 days using visual analogue scale (VAS) and by recording patients need for analgesics on a daily basis. Patients were also evaluated via a self-reporting questionnaire, i.e. Postoperative Symptoms Severity (PoSSe) scale, administered on the seventh postoperative day. RESULTS: Pain scores recorded in Group A were found to be significantly lower as compared to pain scores in Group B in the 5 postoperative days (P < 0.05). Total analgesic intake in Group B was significantly higher (P < 0.05). PoSSe scores were lower in Group A, however, this difference was insignificant (P > 0.05). CONCLUSIONS: According to the data of the current study and within its limits, it appeared that lingual-based four-cornered flap design was superior to the conventional triangular flap regarding the postsurgical discomfort and pain

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Lengua en pradera segada: una manifestación de la sífilis secundaria / Mowed-meadow pattern of the tongue: A sign of secondary syphilis

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