Características odontométricas de las primeras molares permanentes del maxilar superior e inferior en estudiantes de odontología de la Universidad Nacional Federico Villarreal. Lima-Perú / Odontometric characteristics of the first permanent molars of the upper and lower maxilla in dentistry students of the Federico Villarreal National University. Lima Peru

Objetivo: Determinar los diámetros mesiodistal, vestíbulo palatino y vestíbulo lingual, de las primeras molares permanentes de ambos maxilares para la estimación del sexo, en los estudiantes de Odontología de la Universidad Nacional Federico Villarreal, Lima-Perú. Material y métodos: El tipo de investigación empleado fue descriptivo con un diseño no experimental, la técnica aplicada fue la observación directa, la población estuvo constituida por 605 estudiantes. Se realizó la toma de impresiones de ambos maxilares con silicona de condensación para obtener los modelos de estudio, se utilizó un calibrador vernier digital para hacer las medidas mesiodistal y vestíbulo palatino y vestíbulo lingual, las medidas se realizaron a una muestra de 207 modelos de ambos sexos. Resultados: La característica odontométrica con respecto al diámetro vestíbulo -palatino/lingual de ambos maxilares, para el sexo masculino tuvo un diámetro de 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) y 11.02mm (pza.46) y valores de 10.88mm (pza16), 10.93mm (pza.26), 10.77mm (pza.36), y 10.74mm (pza.46), en el sexo femenino; en lo referente a la característica odontométricas mesio-distal se encontró un diámetro de 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) y 11.45mm (pza.46) para el sexo masculino y valores de 10.56mm (pza. 16), 10.58mm (pza.26), 11.10 mm (pza.36), y 11.2mm (pza.46), en el sexo femenino. Conclusión: Los diámetros mesiodistales y vestíbulo palatino fueron mayores en el sexo masculino. (AU)

Objective: To determine the mesiodistal, palatal vestibule and lingual vestibule diameters of the first permanent molars of both jaws for the estimation of sex, in Dentistry students of the Federico Villarreal National University, Lima-Peru. Material and methods: The type of research used was descriptive with a non-experimental design, the applied technique was direct observation, the population consisted of 605 students. Impressions of both jaws were made with condensation silicone to obtain the study models, a digital vernier caliper was used to make the mesiodistal and palatal vestibule and lingual vestibule measurements, the measurements were made on a sample of 207 models of both sexes. Results: The odontometric characteristic with respect to the vestibule-palatal/lingual diameter of both jaws, for the male sex had a diameter of 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) and 11.02mm (pza.46) and values of 10.88mm (pza.16), 10.93mm (pza.26), 10.77mm (pza.36), and 10.74mm (pza.46), in the female sex; Regarding the mesio-distal odontometric characteristic, a diameter of 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) and 11.45mm (pza.46) was found for the male sex. and values of 10.56mm (pza.16), 10.58mm (pza.26), 11.10mm (pza.36), and 11.2mm (pza.46), in the female sex. Conclusion: The mesiodistal and palatal vestibule diameters were greater in males. (AU)

Oral paracoccidioidomycosis: a retrospective study of 95 cases from a single center and literature review

Background: The ecoepidemiological panorama of paracoccidioidomycosis (PCM) is dynamic and still ongoing in Brazil. In particular, data about the oral lesions of PCM are barely explored. The aim of this study was to report the clinicopathological features of individuals diagnosed with oral PCM lesions at an oral and maxillofacial pathology service in Rio de Janeiro, Brazil, in the light of a literature review. Material and methods: A retrospective study was conducted on oral biopsies obtained from 1958 to 2021. Additionally, electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information, and Brazilian Library of Dentistry to gather information from large case series of oral PCM. Results: Ninety-five cases of oral PCM were surveyed. The manifestations were more frequent among males (n=86/90.5%), middle-aged/older adults (n=54/58.7%), and white individuals (n=40/51.9%). The most commonly affected sites were the gingiva/alveolar ridge (n=40/23.4%) and lip/labial commissure (n=33/19.3%); however, one (n=40/42.1%) or multiple sites (n=55/57.9%) could also be affected. In 90 (94.7%) patients, "mulberry-like" ulcerations/moriform appearance were observed. Data from 21 studies (1,333 cases), mostly Brazilian (90.5%), revealed that men (92.4%; male/female: 11.8:1) and individuals in the fifth and sixth decades of life were the most affected (range: 7-89 years), with the gingiva/alveolar ridge, palate, and lips/labial commissure being the sites most frequently affected. Conclusions: The features of oral PCM lesions are similar to those reported in previous studies from Latin America. Clinicians should be aware of the oral manifestations of PCM, with emphasis on the clinicodemographic aspects and differential diagnoses, especially considering the phenomenon of the emergence of reported cases in rural and/or urban areas of Brazil. (AU)

Retrospective comparison of cleftlip/palate patients and normalcontrols: cone beam computedtomograph imaging of foramen Husckhe morphology

The foramen tympanicum, also known as the foramen of Huschke (FH), is a permanent anatomical variation situated in the anteroinferior section of the external auditory canal, posteromedial to the temporomandibular joint. The aim of the study is to determine the prevalence of the FH in Cleft Lip and Palate (CL/P) patients, compared to healthy individuals by using Cone Beam Computed Tomography (CBCT) data. We retrospectively analyzed the CBCT images of 272 individuals, who had been referred to our Oral and Maxillofacial Radiology clinic various reasons. For comparison, 226 randomly selected healthy individuals and 46 CL/P patients (35 unilateral and 11 bilateral) were evaluated. FH in 35 (12.9%) of the 272 individuals; 26 of them healthy individuals, 9 of them CL/P patients. The FH was higher in patients with CL/P (19.6%) than healthy individuals (11.5%). Clinicians should be aware of the variability of TME and especially the FH in the ear region when radiographically examining these sites prior to CL/P surgery to prevent postoperative reconstruction and complications. Moreover, to evaluate these anatomical variations, CBCT

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Capacidad de Disolución del Hipoclorito de Sodio con o sin Activación / Dissolution Capacity of Sodium Hypochlorite with or without Activation

Introducción: Una de las propiedades del hipoclorito de sodio (NaOCl) es la disolución de tejido pulpar remanente después de la instrumentación. Los sistemas de activación del irrigante pretenden mejorar esta propiedad. Este trabajo tiene como objetivo determinar la capacidad de disolución de tejido de NaOCl con y sin activación sónica o ultrasónica en diferentes concentraciones. Metodología: 300 muestras de tejido conectivo de paladar de cerdo de 4,5 * 2 mm obtenidos 1 día antes del estudio, congelado a-15°C en 100% de humedad, fueron pesados en una balanza analítica y sometidos a la acción de NaOCl 1%, 3% y 5% con y sin activación durante 45 minutos, cambiando la solución cada 10 minutos. Se secaron en papel filtro y se pesaron nuevamente. Los datos se analizaron mediante tests Kolmogorov-Smirnov; Kruskal-Wallis y Mann-Whitney. Resultados y Discusión: NaOCl 1% tiene menor capacidad de disolución que mejora levemente al activarlo. NaOCl 3% tiene mejor capacidad de disolución que NaOCl 1%, pero la activación no la mejora significativamente. NaOCl 5% tiene mayor capacidad de disolución, que aumenta con la activación, sin significancia entre activación sónica y ultrasónica, lo que se debería a que la mucosa palatina porcina requiere más tiempo para su disolución completa, y a que el volumen de tejido utilizado es mayor que una pulpa dental. Conclusiones: Bajo las condiciones de este estudio, sólo NaOCl 5% mostró mayor capacidad de disolución con la activación. NaOCl 1% y 3% no mejoraron significativamente con la activación

Introduction: One of the properties of sodium hypochlorite (NaOCl) is dissolution of pulp tissue remaining after instrumentation. Irrigant activation systems aim to improve this property. The objective of this work is to determine tissue dissolution capacity of NaOCl with and without sonic or ultrasonic activation in different concentrations. Methodology: 300 pork palate connective tissue samples of 4.5 * 2 mm obtained 1 day before the study, frozen at-15 ° C in 100% humidity, weighed on an analytical balance and subjected to the action of NaOCl 1%, 3% and 5% with and without activation for 45 minutes, changing the solution every 10 minutes. They were dried on filter paper and weighed again. The data were analyzed by Kolmogorov-Smirnov tests; Kruskal-Wallis and Mann-Whitney. Results and Discussion: NaOCl 1% has a lower dissolution capacity that improves slightly when activated. NaOCl 3% has better dissolution capacity than NaOCl 1%, but the activation does not significantly improve it. NaOCl 5% has greater dissolution capacity, which increases with activation, without significance between sonic and ultrasonic activation, which is due to the fact that the porcine palatine mucosa requires more time for its complete dissolution, since the volume of tissue used is greater than a dental Pulp. Conclusions: Under the conditions of this study, only NaOCl 5% showed greater dissolution capacity with activation. NaOCl 1% and 3% did not improve significantly with activation

Versatilidad del colgajo famm para la cobertura de defectos intraorales / Versatility of the famm flap in intraoral reconstruction / Versatilidade do retalho FAMM na cobertura de defeitos intra-orais

Introducción y Objetivo: El colgajo FAMM (colgajo músculo-mucoso de arteria facial) descrito en 1992 por Pribaz y col, es un colgajo intraoral basado en la arteria facial, compuesto por mucosa oral, submucosa, músculo bucinador, arteria facial y por el plexo venoso correspondiente y puede ser de base inferior (flujo anterógrado) o superior (flujo retrógrado). Es un colgajo versátil que se puede usar en la reconstrucción de defectos de múltiples localizaciones (paladar, lengua o suelo de boca). Con este trabajo pretendemos demostrar su utilidad en la reconstrucción de diferentes defectos intraorales. Material y Método: Presentamos 3 casos en lo que empleamos el colgajo FAMM para reconstrucción intraoral: un paciente con anquiloglosia cicatricial secuela de carcinoma de suelo de boca, un paciente con fístula de paladar secuela de resección tumoral, y un paciente con exposición intraoral de arco mandibular por osteonecrosis secundaria a bifosfonatos. Resultados: Todos los colgajos sobrevivieron al 100% y permitieron una cobertura estable y duradera, con ausencia de complicaciones mayores. Conclusiones: El colgajo FAMM permite la reconstrucción de defectos intraorales y periorales con tejido bien vascularizado y de idénticas características a las de la zona a reconstruir, con baja morbilidad de la zona donante, lo que lo convierte en una excelente opción reconstructiva para defectos de esta región anatómica

Background and Objective: The facial artery musculo-mucosal (FAMM) flap, first described by Pribaz et al. in 1992, is an intraoral flap based on the facial artery. It is composed of mucosa, submucosa, buccinator muscle and the facial artery along with its venous plexus. The design of the flap can be inferiorly-based and rely on antegrade blood flow or superiorly-based with retrograde flow. The FAMM flap is a versatile flap that can be used for the reconstruction of defects of multiple locations (palate, lips, tongue, and floor of the mouth). The purpose of this study is to demonstrate the utility of the FAMM flap in the reconstruction of different intraoral defects. Methods: In this article the authors present 3 cases in which the FAMM flap was used for intraoral reconstruction: one patient with a history of ankyloglossia sequelae of a squamous cell carcinoma of the floor of the mouth; one patient with a palatal fistula sequelae of tumor excision; and one patient with a biphosphonate-related osteonecrosis of the mandible. Results: All flaps survived and provided a stable and reliable coverage of the defect. There were no major complications. Conclusions: The FAMM flap is a well vascularized flap that replaces like with like tissue. Because of its low morbidity, low rate of complications and reliable results, the FAMM flap is an excellent option for reconstruction of small to moderate intra-oral defects

Introdução e Objetivo: O retalho FAMM (facial artery musculo-mucosal flap), descrito em 1992 por Pribaz et al., é um retalho intra-oral baseado na artéria facial. É composto por mucosa oral, submucosa, músculo bucinador, artéria facial e pelo plexo venoso correspondente, podendo basear-se inferior (fluxo anterógrado) ou superiormente (fluxo retrógrado). É um retalho versátil que pode ser utilizado nareconstrução de defeitos em múltiplas localizações (palato, lábio, língua, pavimento da boca). Com este trabalho pretende-se demonstrar a utilidade do retalho FAMM na reconstrução de diferentes defeitos intra-orais. Material e Métodos: Os autores apresentam 3 casos em que se utilizou o retalho FAMM para reconstrução intra-oral: um doente com anquiloglossia cicatricial sequelar de carcinoma do pavimento da boca; uma doente com uma fístula do palato sequela de excisão tumoral; e um doente com exposição intra-oral do arco mandibular anterior por osteonecrose secundária a bifosfonatos. Resultados: Todos os retalhos sobreviveram a 100% e permitiram uma cobertura estável e duradoura, na ausência de complicações major. Conclusão: O retalho FAMM permite a reconstrução de defeitos intra e peri-orais com tecido bem vascularizado e de características idênticas à zona a reconstruir, com baixa morbilidade da zona dadora, o que o torna uma excelente opção reconstrutiva para defeitos desta região anatómica

Patent nasopalatine ducts: Evidence to support persistence of the vomeronasal system?

The vomeronasal system is comprised of the nasopalatine duct and the vomeronasal organ. While this system functions in chemodetection in mammals, its presence and function in adult humans remains to be clearly elucidated. Here, a case of asymptomatic, bilateral, patent nasopalatine ducts is presented. We postulate that the presence of these patent structures represents persistence of the embryological nasopalatine duct component of the vomeronasal organ into adult life

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Nonsyndromic cleft lip and palate, gastric cancer and tooth agenesis

Background: To determine the frequency of nonsyndromic cleft lip and/or palate (NSCL/P) in first-degree relatives and to analyze the prevalence of tooth agenesis in patients with gastric cancer. Material and Methods: This cross-sectional, observational, case-control study included 798 patients attended at hospital Santa Casa in Montes Claros, Minas Gerais and Alfa Institute of Gastroenterology of the Federal University of the Minas Gerais. Information on basic demographic data and tooth agenesis of both groups and their family history of NSCL/P in first-degree relatives were evaluated. The collected information was stored in a database and analyzed using statistical program SPSS® version 21.0 and the values with p<0.05 were considered statistically significant. Results: Of the 798 patients, 113 (14.16%) consisted of the case group and 685 of the control group (85.84%). Non-Caucasian males were the most affected, although no differences among the groups were detected. Of all participants (n=798), 66 (8.27%) presented tooth agenesis and 25 (3.13%) presented oral cleft in first degree relative. Conclusions: Our results no found increase in the frequency of tooth agenesis in patients with gastric cancer and in the frequency of NSCL/P in the first-degree relatives of patients with gastric cancer (AU)

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Preliminary evaluation of near-infrared vein visualization technology in the screening of palatal blood vessels

Background: Avoidance from palatal blood vessel rupture is a major concern during the palatal soft tissue graft surgery. There is no defined chair-side and case-specific palatal blood vessel detection approach to facilitate the harvesting process. The objective of this pilot study is to assess the feasibility of a near-infrared vein visualization system in the screening process of palatal blood vessels. Material and Methods: An extraoral vein visualization device (AccuVein AV400) was applied to a total of 304 hemi-maxilla of 152 individuals by two blind examiners. The study groups were classified according to their maximum inter-incisal measurements. The distances between the coronal border of the vessel image and the mid-palatal gingival margins of the adjacent teeth were measured and in each group. The correlations among the measurements were evaluated within groups. Results: The blood vessel to the adjacent teeth measurements exhibited no statistical difference between both examiners in all subjects (p<0.001). Correlations between the examiners gradually increased in all groups as the mouth opening rates of the subjects were increased (p<0.001). Conclusions: In the current state, screening of the palatal blood vessels via near-infrared vein visualization technology seems to be not suitable for every individual due to the restrictive effect of mouth opening. However, the promising results of this preliminary study demonstrated increasing consistency between the measurements of the examiners as the inter-incisal distance increase which emphasized the need an intraoral version of the device. Considering the lack of local decision-making technology for the detection of palatal blood vessels, further studies are required for development and optimization of these systems (AU)

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Protocolo para la planificación quirúrgica en las clínicas de labio y paladar hendidos en la zona noroeste de la República Mexicana / Guidelines for the surgical planning at the cleft lip and palate clinics located in the northwest of Mexican Republic

Introducción y Objetivo. Las fisuras de labio y paladar son las malformaciones craneofaciales más frecuentes. Su tratamiento debe ser multidisciplinario y secuencial. Generalmente los pacientes requieren más de una cirugía reconstructiva durante su infancia y a veces es indispensable, en la edad adulta, el tratamiento dental, de audición, lenguaje, crecimiento facial y psicológico. Es necesaria la colaboración de múltiples profesionales de la salud que se mantendrán al tanto del progreso del paciente en su especialidad y se apoyarán para lograr un resultado exitoso y con buena calidad de vida. El objetivo del presente trabajo es estandarizar el manejo quirúrgico de las fisuras de labio y paladar en los pacientes atendidos en las clínicas ubicadas en Tijuana y Ensenada, y próximamente Mexicali y Hermosillo, ciudades localizadas al noroeste de México. Material y Método. En las clínicas de Labio y Paladar Hendido de Tijuana y Ensenada, la colaboración de profesionales en Cirugía Plástica, Odontología Pediátrica, Ortodoncia, Otorrinolaringología, Terapia de Lenguaje, Terapia Familiar, Psicología Pediátrica y otras disciplinas, ha logrado un seguimiento del tratamiento multidisciplinario de hasta 10 años. Los resultados estéticos y funcionales han sido óptimos cuando la cirugía reconstructiva se ha complementado con estas otras disciplinas. Resultados. Las fisuras de labio y paladar hendidos deben ser atendidas desde el nacimiento, apoyando psicológicamente a los padres, instruyéndolos sobre la alimentación y cuidados especiales de estos pacientes, preparando al niño para su primera cirugía que en muchos casos es la queiloplastia, y para la segunda, la palatoplastia, y enfatizando el apoyo por Odontopediatría y Ortodoncia para la salud dental y moldeamiento de los segmentos maxilares y de los cartílagos alares, así como la terapia del lenguaje cuando el paciente empieza a estructurar su habla. La evaluación audiológica es importante desde el nacimiento y la colocación de tubos de ventilación evitará problemas de audición y del habla si está indicada. Conclusiones. A lo largo de la infancia y hasta la edad adulta, los pacientes pueden requerir correcciones labiales y nasales, colocación de injertos óseos alveolares, faringoplastias, colgajos faríngeos, distracción maxilar y finalmente, cirugía ortognática para los problemas de oclusión o de crecimiento facial. Antes de llevarse a cabo cualquiera de estas cirugías, es indispensable la evaluación conjunta por el equipo multidisciplinario para lograr los mejores resultados (AU)

Background and Objective. The lip and palate clefts are the most frequent congenital craneofacial malformations. Their treatment must be multidisciplinary and sequential. Most cases need more than one reconstructive surgery during the patient's childhood and can extend to additional surgery in adulthood. Dental, auditory, speech, facial growth and psychological management are required. This is why all of the professionals that work in a cleft team should always communicate to obtain the most successful results. The objective of the present study is to standardize the management of lip and palate fissures in patients treated at the clinics located in Tijuana and Ensenada, and soon Mexicali and Hermosillo, cities located in the Northwest of Mexico. Methods. The patients involved have been treated in clinics for clefts in Tijuana, Ensenada, and very soon in Mexicali and Hermosillo, cities located in the Northwest of Mexico. In the cleft lip and palate clinics in Tijuana and Ensenada, the collaboration between Plastic Surgery, Pediatric Odontology, Orthodontics, Otorhinolaryngology, Speech Therapy, Family Therapy, Child Psychology and other disciplines has been crucial to treat and follow up on patients during the past 10 years. The esthetic and functional results have been optimal when the surgery is complemented by these other disciplines. Results. For this approach, the cleft lip and palate patient has to be evaluated as early as possible, and parents must be instructed in nutrition and other special needs, and in getting the patient ready for the first surgery which in most cases is the lip repair and the second, if needed, is the palate repair. It always has to be emphasized that the pediatric odontologist and the orthodontist play an important role in molding the nasal cartilages as well as the maxillary segments before the surgery, as well as dental health. The speech therapist will have an important role when the patient's speech development starts and an early audiologic assessment will guide the treatment with ear tubes placed by the otorhinolaryngologist in order to avoid auditory and speech problems. Conclusions. During their lifetime, these patients may need other surgical procedures such as lip and nasal revisions, alveolar bone graft, pharyngoplasties, pharyngeal flaps, maxillary distraction or orthognatic surgery; this last one when there have been facial growth problems or malocclusions. Before any of these surgeries, the exchange of assessment and therapeutic plans by the multidisciplinary team is necessary to obtain the best results (AU)

Estrategia quirúrgica reconstructiva en un caso de duplication palatina compleja / Surgical reconstructive approach in a case of complex palatine duplication

La duplicación palatina es una malformación congénita rara de las estructuras craneofaciales. En la mayoría de casos se asocia a otras malformaciones faciales de diferente grado de severidad. Presentamos el caso de un paciente con duplicación de paladar y fisuras faciales raras, con el planteamiento y la estrategia quirúrgica para su reconstrucción. Con el apoyo de las imágenes escenográficas con reconstrucción tridimensional se realizó el planeamiento quirúrgico. Programamos resección en cuna de los segmentos mediales de cada paladar, a cada lado de la fisura facial, y transferencia medial en bloque del maxilar comprometido. La gran variación anatómica encontrada durante el procedimiento, 2 orificios infraorbitarios divididos por la fisura facial, y la alteración del seno maxilar del lado comprometido, nos impusieron un reto quirúrgico para la reconstrucción. Logramos la resección en bloque planeada recreando un único paladar. La evolución postoperatoria fue favorable, no se presentaron complicaciones y la oclusión funcional resultante fue la esperada (AU)

The palatine duplication is an uncommon congenital malformation of the craniofacial skeleton that is frequently associated to craniofacial malformations of different grades of severity. A case of palatine duplication associated to a rare craniofacial cleft, the planning and the surgical approach is presented. 3D reconstruction tomography images were used to guide the surgical planning. A wedge resection of both medial palatal arches with medial displacement were done. The highly disrupted maxillary anatomy made the reconstruction planning a surgical challenge. The wedge resection successfully achieves a single and anatomical palate. The postoperative follow shown no complications and the desired occlusion was obtained (AU)

What is the role of elective neck dissection in patients with squamous cell carcinoma of the upper jaw? / ¿Cual es el papel de la disección cervical electiva en el carcinoma escamoso del maxilar superior?

Background. Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma (SCC) of the upper jaw is controversial. The purpose of this study was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected. Methods. We retrospectively reviewed 20 patients treated of SCC of the maxillary alveolus and hard palate between 2005 and 2012. Results. Six (30%) patients presented with cervical lymph metastasis at initial diagnosis. Two of the14 patients who initially had no signs of metastasis in the neck developed cervical metastasis during follow-up and another patient with cervical metastasis at diagnosis developed contralateral cervical metastasis. All the patients with cervical metastasis (45%) were pT3/T4 SCC. Cervical metastasis developed at a mean of 11.6 months. Conclusions. Despite this study being limited by its retrospective nature and the sample size, based on our findings and on an extensive review of the literature, we may conclude that cervical metastasis from maxillary alveolus and hard palate SCC appears most frequently in pT3/T4 tumors. Therefore, we find elective neck dissection appropriate for patients with pT3/T4 SCC of the upper jaw (AU)

Introducción. El tratamiento quirúrgico del cuello clínicamente negativo en el carcinoma de células escamosas (CCE) del maxilar superior es controvertido. El objetivo de este estudio es mostrar la incidencia de metástasis cervical y analizar si la disección cervical electiva está justificada cuando el cuello no está afectado de inicio. Métodos. Revisamos retrospectivamente 20 pacientes tratados por CCE de paladar duro y reborde alveolar superior entre 2005 y 2012. Resultados. Seis (30%) pacientes presentaron metástasis cervical de inicio. Dos de los 14 pacientes que inicialmente no tuvieron signos de metástasis cervical la desarrollaron durante el seguimiento, y otro paciente con metástasis cervical al inicio desarrolló una metástasis cervical contralateral. Todos los pacientes con metástasis cervical (45%) fueron pT3/T4 CCE. El tiempo medio de aparición de metástasis cervical fue de 11,6 meses. Conclusiones. A pesar de las limitaciones de este estudio (naturaleza retrospectiva, limitado número de pacientes), y tras analizar los resultados obtenidos y revisar la literatura, podemos concluir que la metástasis cervical de CCE de maxilar superior aparece con mayor incidencia en tumores pT3/T4. Por lo tanto, creemos conveniente realizar disección cervical electiva en pacientes con CCE T3/T4 de maxilar superior (AU)

Satisfaction and quality of life with palatal positioned implants in severely atrophic maxillae versus conventional implants supporting fixed full-arch prostheses

BACKGROUND: To evaluate satisfaction and quality of life in patients with palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic supporting fixed full-arch prostheses. MATERIAL AND METHODS: A clinical retrospective study was performed of patients that were rehabilitated with full-arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) and with class III maxilla and treated with implants well-centered in the alveolar ridge and completely surrounded by bone (control). Ten-cm visual analogue scales (VAS) (range 1-10) and the OHIP-14 (Oral Health Impact Profile) questionnaire were used respectively to estimate patient satisfaction and quality of life after implant therapy. Statistical analysis was performed applying Mann-Whitney Test using alpha set at 0.05. RESULTS: Mean global and specific satisfaction - except for self-esteem - were superior for the test group than the control group, although differences were not statistically significant. Regarding quality of life, the reported incidence of problems was lower in the test group for all the studied ítems except for 'problems at work'. However, differences were not statistically significant in any case. CONCLUSIONS: Despite the limitations of the study (retrospective and nonrandomized design) the results suggest that the prosthesis design needed to rehabilitate palatally positioned implants (more coverage of palate) does not lead to lower satisfaction and quality of life of patients, compared to patients treated with implants placed centered and conventional design prostheses that do not cover the palate

Palatal positioned implants in severely atrophic maxillae versus conventional implants to support fixed full-arch prostheses: controlled retrospective study with 5 years of follow-up

BACKGROUND: To evaluate soft tissue conditions and bone loss around palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic maxillae after a minimum follow-up of 5 years. MATERIAL AND METHODS: A clinical retrospective study was performed of patients that were rehabilitated with full-arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) and with class III maxilla and treated with implants well-centered in the alveolar ridge and completely surrounded by bone (control). The following variables were assessed: age, sex, frequency of toothbrushing, smoking, type of prosthesis, type of implant, implant success, amount of buccal keratinized mucosa, buccal retraction, probing depth, plaque index, modified bleeding index, presence of mucositis or peri-implantitis and peri-implant bone loss. Statistical analysis was performed applying Chi2 Test and Student's t-test using alpha set at 0.05.RESULTS:A total of 57 patients were included: 32 patients with 161 palatal positioned implants (test) and 25 patients with 132 well centered implants (control). No statistically significant differences were found regarding age, sex and smoking, but test group patients reported a significantly higher frequency of daily toothbrushing. Implant success rates were 96.9% for test group implants and 96.0% for control group implants. Peri-implant mucosa retraction was significantly higher in the control group than in the test group (p=0,017). No significant differences were observed either for all the other assessed clinical parameters or for peri-implant bone loss.Conclusions: Despite its limitations the outcomes of the present study suggest that palatal positioned implants may be a good treatment alternative for patients with severe horizontal maxillary alveolar bone atrophy. Palatal positioned implants presented similar success rates, soft tissue conditions and peri-implant bone loss than well-centered implants placed completely surrounded by bone in non-atrophic ridges

Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions

Aims: The aim of this study was to evaluate the vestibular-palatal diffusion of 4% articaine with epinephrine 1:100,000 and 1:200,000, in impacted maxillary third molar extractions, without palatal injection. Materials and Method: Two hundred teeth were selected from patients age 15 to 46. Patients were divided into 4 groups: 1A, were anesthetized with 4% articaine 1:100,000 and the surgery was initiated 5 minutes following anesthesia. 1B, used 4% articaine 1:100,000 but the surgery was started 10 minutes after anesthesia. 2A, used 4% articaine 1:200,000 the surgery was started 5 minutes after. 2B, used 4% articaine 1:200,000 but 10 minutes was allowed for anesthetic diffusion before the initiation of in groups (50 extractions each) only buccal vestibule anesthesia was initially administered (i.e. no palatal injections were used). Results: The rate of sufficient vestibule-palatal diffusion, as determined by the lack of necessity of supplemental palatal anesthesia, was: 1A(84%), 1B(98%), 2A(78%), 2B(82%). Chi-square (X2) and residual analyses showed that a higher vestibule-palatal diffusion was obtained using 4% articaine 1:100,000 with a period of 10 minutes (p<0.05). Conclusions: Most of the extractions could be performed only with vestibule anesthesia. However, vasoconstrictor concentration and the time interval between administration of the anesthetic and initiation of surgery did influence buccal vestibule-palatal diffusion of 4% articaine in the extraction models used (AU)

Macroglosia y el síndrome de Down / No disponible

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Telangiectasia hemorrágica hereditaria / Hereditary hemorrhagic telangiectasia

La telangiectaasia hemorrágica hereditaria se caracteriza por displasia de capilares y pequeños vasos que pueden sangrar ocasionalmente. Presentamos el caso de una paciente de 69 años con lesiones papulosas diminutas de color rojo vivo localizadas en labios, lengua y paladar (AU)

Hereditary hemorrhagic telangiectasia is characterised by capillary and small blood vessel malformations which may occasionally cause bleeding. We present a case of a 69 year old woman with small, bright red, papulous lesions on the lips, tongue and palate (AU)

Reconstrucción del esfínter velofaríngeo en la fisura del paladar secundario: alternativa quirúrgica / Reconstruction of velopharyngeal sphincter in secondary cleft palate: surgical alternative

Existen numerosas técnicas quirúrgicas para la reparación de las fisuras del paladar secundario (FPS). Desde 1998, en niños con FPS usamos la técnica de Wardill-Kilner modificada, realizando sección de la mucosa nasal a nivel de la inserción de los músculos del paladar en las apófisis palatinas, consiguiendo retroceder y reorientar las fibras musculares sin disección de las mismas, disminuyendo así los riesgos de hemorragia y fibrosis, simplificando la intervención. Permite un tiempo operatorio y de internado corto. El objetivo de nuestro estudio fue evaluar los resultados de esta técnica principalmente en el desenvolvimiento del habla en 73 niños operados desde 1998 hasta 2000 en nuestro hospital. Verificamos una competencia del esfínter velofaríngeo, con óptimos resultados en el habla en 88,8% de los casos (AU)

There are numerous surgical procedures for the repair of Cleft Palate (CP). Since 1998, in children with CP we use a modified Wardill-Kilner technique, with a large section of the nasal mucous layer at the level of the muscular insertion on the hard palate and lateral nasopharingeal wall, obtaining a push-back and reorientation of the muscular fibres without dissection, diminishing this way the risks of haemorrhages and fibrosis, simplifying the intervention. It allows a lower operative time and a short internment. The aim of our study was to evaluate the results of this operative procedure specially in the development of the speech in 73 children operated on from 1998 until 2000 in our hospital. We verify a competence of the velopharingeal sphincter with ideal results in speech in 88,8% of the cases (AU)

Necrosis palatina en el lactante. A propósito de un caso / Palatal necrosis in children. Case report

La necrosis palatina secundaria a patología infecciosa es un cuadro excepcional del que existen muy pocas referencias en la literatura. Presentamos un caso de un paciente de 6 meses de edad que tras un cuadro de otitis media supurada, presenta necrosis palatina que afecta al paladar duro y blando, con cultivos positivos a Pseudomona aeruginosa, provocando una ausencia casi completa del paladar, equivalente a una fisura palatina bilateral completa (AU)

Palate necrosis as a consequence of palate infection it’s an exceptional condition about there´s not too much references at literature. We present a case of a 6 months old child who present a palatal necrosis after a supurative medial otitis that involved hard and soft palate, with positive culture for pseudomona aeruginosa causing a almost complete absence of the palate that simulate a bilateral palatal cleft (AU)

Incisiones verticales en SARPE / No disponible

La expansión rápida de paladar asistida quirúrgicamente (SARPE)es una de las opciones terapeuticas de los transtornos transversales delmaxilar superior. Presentamos nuestra experiencia inicial con una variantetécnica consistente en una corticotomía de la pared lateral del maxilar combinadacon una osteotomía palatina media transincisal, y efectuadas a travésde tres pequeñas incisiones verticales

Surgically assisted rapid palatal expansion (SARPE)is one of the therapeutic options for the correction oftransverse maxillary collapse. We present our initial experiencewith a technique consisting in a lateral corticotomy of themaxilla plus a transincisal midpalatal osteotomy, bothperformed through minimal vertical incisions

Palatal abnormalities in the developing rat induced by retinoic acid

Palatogenesis is a complex developmental processthat requires two main events: elevation andthen fusion of the palatal shelves. These processesare disrupted by teratogens such as retinoicacid (RA) and genetic defects, resulting in variousmalformations (including cleft palate). Usinghistological and immunohistochemical techniques,the effects of different isomers of RA, administeredin various concentrations to pregnantrats on different gestational days (GD), were assessedfrom observations of the state of palataldevelopment on GD 18 in foetuses without exencephaly.Varying degrees of clefting of thepalate were observed, from failure of elevationof the palatal shelves to failure of fusion in themidline. This study shows that all-trans-RA isthe most teratogenic RA isomer in terms of ratpalatal abnormalities. It also supports previousfindings that the timing of administration of alltrans-RA is more critical than the concentration,with treatment between GD 10 and 10.5 havingthe most severe effects. Previous histologicalstudies also suggested that RA is associatedwith the appearance of ectopic cartilages withinthe developing palate of foetuses showing exencephaly.In this investigation, immunohistochemicallabelling of the foetal material with antibodiesthat recognise epitopes present in linkproteins 1, 2, and 3 (8A4), chondroitin-4-sulphatestubs (2B6), and G1 and chondroitin sulphateattachments (7D1) present in aggrecan (associatedwith hyaluronan in cartilage) showedno signs of ectopic cartilage formation within the palate at GD18. Internal controls of the cartilagesof the nasal septum, vomeronasal cartilage, andMerkel’s cartilage labelled intensely and appearedmorphologically normal (AU)

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