Professional diagnostic delay in osteosarcomas of the jaws

A series of 20 consecutive patients with an osteosarcoma of the jaws has been evaluated with regard to possible professional diagnostic delay. When set at an arbitrarily chosen period beyond three months, professional delay occurred in 15 patients, the mean being 21 months and the median 11 months. In five of the 15 patients a wrong diagnosis has been rendered on the biopsy specimen, being fibrous dysplasia (2x), osteoma (2x) and, in case of palatomaxillary swelling, pleomorphic adenoma (1x). In the other ten patients the initial clinicoradiographic features were misleading and apparently not indicative of a malignancy, except for one patient in whom a distinct widening of the periodontal ligament, as expressed on a periapical film, has been overlooked or not properly interpreted. It has not been possible to assess the possible influence of the delayed diagnosis on the prognosis

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Investigation of PTEN promoter methylation in ameloblastoma

BACKGROUND: Phosphatase and tensin homolog (PTEN) acts as a tumor suppressor gene. Inactivation of PTEN has been reported in various types of cancers. PTEN promoter methylation possibly underlies PTEN inactivation, which results in tumorigenesis. The aim of this study was to investigate whether PTEN promoter methylation contributes to PTEN inactivation in ameloblastoma and its associated protein expression. MATERIAL AND METHODS: In total, 20 fresh-frozen ameloblastoma samples were evaluated for PTEN promoter methylation using methylation-specific polymerase chain reaction (MS-PCR). A subset of 10 paraffin-embedded ameloblastoma samples was examined for PTEN expression through immunohistochemistry. Four primary cultured ameloblastoma cells were investigated for PTEN promoter methylation and PTEN transcriptional expression via reverse transcription PCR. RESULTS: PTEN promoter methylation was detected in 65% (13/20) of the ameloblastoma samples. Of 10 ameloblastoma samples, 4 exhibited reduced PTEN expression. Of 5 samples with methylated PTEN, 3 (60%) were associated with loss of PTEN expression. However, PTEN expression was detected in 4 (80%) of 5 samples with unmethylated PTEN. In addition, 3 (75%) of 4 primary ameloblastoma cell cultures exhibited an inverse correlation between PTEN promoter methylation and PTEN transcription level. CONCLUSIONS: PTEN promoter methylation is found in a number of ameloblastomas but not significantly correlated with loss of PTEN expression. Genetic or epigenetic mechanisms other than PTEN promoter methylation may contribute to PTEN inactivation in ameloblastoma tumor cells

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High frequency of BRAF V600E mutation in Iranian population ameloblastomas

BACKGROUND: Ameloblastoma is a common locally invasive but slow-growing neoplasm of the jaws with an odontogenic origin. Association between BRAF V600E mutation and clinicopathologic features and behavior of ameloblastoma remains controversial. This study aimed to evaluate BRAF V600E gene mutation and expression of its related proteins with clinicopathologic parameters in conventional ameloblastoma. MATERIAL AND METHODS: 50 Formalin-fixed paraffin-embedded blocks were included in this study. Immunohistochemistry was done using rabbit monoclonal BRAF V600E mutation-specific antibody VE1. Quantitative real-time polymerase chain reaction assay was used for evaluating of BRAF V600E mutation. RESULTS: Expression of BRAF V600E antibody was Positive in 42 out of 50 cases (84%). 46 (92%) out of 50 specimens showed BRAF V600E mutation. There were 13 cases of recurrence (26%). 3 out of 4 cases with negative mutations did not show recurrence. CONCLUSIONS: We report the highest frequency (92%) of BRAF V600E mutation in ameloblastomas in the Iranian population. Although there was not a significant association between BRAF V600E-positive immunoexpression and recurrence and clinicopathologic parameters, its high frequency could emphasize its role as a therapeutic marker in the future

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Primordial odontogenic tumor: A systematic review

BACKGROUND: The primordial odontogenic tumor (POT) is a recently described benign entity with histopathological and immunohistochemical features suggesting its origin during early odontogenesis. AIM: To integrate the available data published on POT into a comprehensive analysis to better define its clinicopathological and molecular features. MATERIAL AND METHODS: An electronic systematic review was performed up to September 2019 in multiple databases. RESULTS: A total of 13 publications were included, representing 16 reported cases and 3 molecular studies. The mean age of the affected patients was 11.6 years (range 2-19), with a slight predominance in males (56.25%). The posterior mandible was the main location (87.5%), with only two cases affecting the posterior maxilla. All cases appeared as a radiolucent lesion in close relationship to an unerupted tooth. Recurrences have not been reported to date. Microscopically, POT comprises fibromyxoid tissue with variable cellularity surrounded by a cuboidal to columnar odontogenic epithelium but without unequivocal dental hard tissue formation. A delicate fibrous capsule surrounds (at least partially) the tumor. The epithelial component shows immunohistochemical positivity for am-elogenin, CK19, and CK14, and variable expression of Glut-1, Galectin-3 and Caveolin-1, Vimentin, p-53, PITX2, Bcl-2, Bax and Survivin; the mesenchymal tissue is positive for Vimentin, CD90, p-53, PITX2, Bcl-2, Bax, and Survivin, and the subepithelial region exhibits the strong expression of Syndecan-1 and CD34. The Ki-67 index is low (<5%). The negative or weak expression of dentinogenesis-associated genes could explain the inhibition of dentin and subsequent enamel formation in this neoplasm. CONCLUSION: POT is an entity with a well-defined clinicopathological, immunohistochemical and molecular profile that must be properly diagnosed and differentiated from other odontogenic lesions and treated consequently

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SOX2 and BCL-2 Expressions in Odontogenic Keratocyst and Ameloblastoma

BACKGROUND: The purpose of this experimental study was to compare the immunohistochemical expression of SOX2 and BCL-2 in Odontogenic Keratocyst (OKC) and Ameloblastoma (AB) specimens, and to identify a possible correlation in their expression.MATERIAL AND METHODS: Immunohistochemical analysis was performed to evaluate SOX2 and BCL-2 expression in OKC (n = 20) and AB (n = 20). The immunoexpression was analyzed by a quantitative and qualitative scoring system. The comparison between the immunoexpression of SOX 2 and BCL-2 was assessed by the Mann-Whitney U-test. Spearman's correlation coefficient evaluated the correlation between SOX2 and BCL-2 expressions.RESULTS: SOX2 and BCL-2 expression was observed in all specimens of OKC in the full thickness of the epithelium lining. SOX2 immunostaining was higher in OKC, in comparison with AB samples (P<0.05). BCL-2 immunostaining between OKC and AB was not statistically significant. There was no significant correlation between SOX2 and BCL-2 in OKC and AB specimens.CONCLUSIONS: SOX2 and BCL-2 expressions in OKC may suggest their relationship with the biological behavior of this lesion, and the higher expression of SOX2 might be an upstream influence on the Hh signaling pathway

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Tratamiento del tumor odontogénico queratoquístico: revisión sistemática / Surgical treatment of odontogenic keratocystic tumor: a systematic review

Introducción: El queratoquiste odontogénico (QO) se considera hoy en día un tumor odontogénico benigno. A pesar de esto, tiene un carácter agresivo debido fundamentalmente a su potencial expansivo a nivel local y a su alta capacidad de recidiva. Actualmente, existen diferentes variedades terapéuticas que se relacionan directamente con las tasas de recurrencia de este tipo de tumor. Objetivo: El objetivo de este estudio es analizar las tasas de recurrencia de las diferentes modalidades de tratamiento del QO. Material y método: Siguiendo las recomendaciones PRISMA se realizó una revisión sistemática en diferentes bases de datos analizando las tasas de recurrencia de distintas opciones terapéuticas del QO. Resultados: El porcentaje medio de recurrencia de los 11 artículos revisados fue del 26,8 %, siendo la resección en bloque el tratamiento con menores tasas de recidiva (0 %) y la marsupialización el tratamiento que mayor porcentaje de recurrencia presentó (45,8 %). Discusión: La recidiva se relaciona directamente con la posibilidad de que restos del tumor o del epitelio que lo rodea puedan permanecer en la cavidad después del tratamiento. Por ello, la resección en bloque es el tratamiento que menos recurrencia presenta. Sin embargo, la agresividad de esta modalidad terapéutica no está justificada en todos los casos, existiendo otras variantes muy eficaces como la enucleación, ya sea sola o en combinación con terapias coadyuvantes como la aplicación de solución de Carnoy. Conclusiones: El tratamiento resectivo presenta las menores tasas de recurrencia, aunque se considera que el QO puede ser abordado de una manera más conservadora dada su naturaleza benigna

Introduction: The odontogenic keratocystic (OK) is considered nowadays as a benign odontogenic tumor. Nevertheless, it has an aggressive nature due mainly to its local expansive potential and its high recurrence rate. Currently, there are different therapeutic approaches that are directly related to the recurrence rates of this type of tumor. Objective: The objective of this study is to analyze the recurrence rates of the different treatment modalities of the OK. Material and method: Following PRISMA recommendations, it was perfomed a systematic review in different databases analyzing the recurrence rates of different therapeutic options of the OK. Results: The average percentage of recurrence of the 11 articles reviewed was of 26,8 %, being resection the treatment with lower recurrence rates (0 %) and marsupialization the treatment with the highest percentage of recurrence (45,8 %). Discussion: Recurrence is directly related to the possibility that parts of the epithelium may remain in the cavity after treatment. Therefore, resection is the treatment with the least recurrence. However, the aggressiveness of this therapeutic modality is not justified in all cases. There are other very effective variants such as enucleation either alone or in combination with adjuvant therapies such as Carnoy's solution application. Conclusions: Resective treatment has the lowest recurrence rates although it is considered that the OK can be approached in a more conservative way due to its benign nature

Clinicopathological analysis of odontogenic tumors over 22 years period: Experience of a single center in northeastern Brazil

BACKGROUND: Odontogenic tumors (OTs) are uncommon neoplastic lesions of the maxilla and mandible, which present difficult diagnosis and therapeutics. This paper aims to determine the frequency and distribution of OTs, over a period of 22 years, at a public university in Northeastern Brazil. MATERIAL AND METHODS: We reviewed all cases of OTs from oral pathology laboratory of Federal University of Rio Grande do Norte (UFRN), from 1996 to 2017. The tumors were classified according to the latest (2017) World Health Organization Classification of Tumors. Data on age, gender, anatomic site, symptomatology, radiographic findings and tumor size were analyzed. RESULTS: In the analyzed period, 247 cases of OTs were diagnosed. Epithelial tumors were more common with 127 cases (51.8%). The most common tumors were ameloblastoma (n = 112 / 45.4%), odontoma (n = 89 / 36.1%) and odontogenic myxoma (n = 17 / 6.9%). Malignant odontogenic tumors were extremely rare in the studied population with only 2 cases (0.8%) of diagnosed carcinomas. These tumors were diagnosed in a wide age range, from 5 to 81 years, being more common in the second and third decades of life. In general, the mandible was the most affected anatomic site (n = 162/66%) and the mandible:maxilla ratio was of 2:1. Ameloblastoma was the tumor with the highest number of symptomatic cases (n = 26) and with the highest mean size (cm) with 4.5 cm. CONCLUSIONS: Odontogenic tumors were rare in the sample studied (2.2%), with ameloblastoma and odontoma being the most common tumors. Continuous studies that show the characteristics of these lesions are fundamental, especially after modifications in the international classification

Sarcoma de Kaposi en región oral y maxilofacial, una neoplasia olvidada / Kaposi's sarcoma in the oral and maxillofacial region: a forgotten neoplasia

El VIH-sida es un problema de salud pública en el mundo. En 2014 se notificaron 9.888 casos nuevos en México y se estima que la mitad de los pacientes desconocen ser portadores de la enfermedad. El sarcoma de Kaposi asociado a sida (SK-sida) es un marcador de progresión de la enfermedad y de inmunosupresión. Aunque la incidencia de SK-sida en la cavidad bucal ha disminuido notablemente desde el acceso universal al tratamiento retroviral altamente activo, existen estudios en la Ciudad de México que establecen una incidencia de esta neoplasia en un 5%. El síndrome de reconstitución inmunológica asociado al SK-sida y linfoedema facial es una complicación potencialmente mortal. La falta de entrenamiento en el diagnóstico bucal del SK-sida y su relativa baja incidencia pueden hacer que para el clínico pase desapercibida esta neoplasia en el examen de rutina, siendo este un signo clínico característico de inmunosupresión. En este artículo se realiza una revisión del SK bucal asociado al sida (AU)

HIV-AIDS is still a worldwide public health problem. In 2014, 9,888 new cases were reported in Mexico, and it is estimated that half of those patients are unaware they suffer the disease. Kaposi's sarcoma associated with AIDS (KS-AIDS) is an indicator of the progression of this disease and immunosuppression. Although the incidence of KS-AIDS in the oral cavity has drastically decreased since the universal access to highly active antiretroviral treatment, several studies in Mexico City have reported an incidence of this neoplasia of 5%. The immune reconstitution syndrome associated with KS-AIDS and facial lymphoedema is a potentially life-threatening complication. Lack of training in the diagnosis of KS-AIDS, as well as its relatively low incidence, may cause this neoplasia to go unnoticed by the clinician, this being a clinical sign of immunosuppression. This article presents a review of oral KS associated to AIDS (AU)

The Epidemiology, treatment, and complication of ameloblastoma in East-Indonesia: 6 years retrospective study

Background: Ameloblastoma is a neoplasm classified as a benign epithelial odontogenic tumor of the jaws, grow slowly and are locally invasive. The aim of the present study was to investigate the incidence, treatment, and complication of patients with ameloblastoma in East-Indonesia during six years retrospective study. Material and Methods: This retrospective study included 84 patients who were diagnosed with ameloblastoma from 2011 to 2016. There were 56 patients with treatment data available. Data from each patient, including gender, age, histologic type, the size of the tumor, radiologic form, tumor location, type of treatment, and complication were reviewed and analyzed retrospectively. Results: Fourteen patients were diagnosed with unicystic ameloblastoma (25%), thirty two patients with multicystic follicular ameloblastoma (57%) and ten patients with an unspecified multicystic ameloblastoma (18%). A total of about 35 patients were treated conservatively (62.5%) and 21 patients were treated radically (37.5%). Swelling was present as a pre-operative complication in all 56 cases (100%). There were no complaints concerning speech. Conclusions: The majority findings of the histologic type were multicystic ameloblastoma and their location were in the mandible. Most ameloblastoma were treated conservatively and reconstructions were made with only titanium plates and not bone graft (AU)

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Metástasis en región maxilofacial de carcinoma renal: serie de casos / Renal Cell Carcinoma metastases in the maxillofacial area: Case series

El carcinoma renal es un tumor de evolución imprevisible. A veces las metástasis son el debut de la enfermedad, mientras que en otras, éstas se manifiestan años tras el tratamiento del primario. Se presentan 4 casos clínicos de metástasis atípicas de carcinoma renal en región de cabeza y cuello: glándula parótida, hueso mandibular, encía adherida molar y espacio masticador. Se revisa la fisiopatología, clínica, histología y manejo del cáncer renal metastásico en esas localizaciones

Renal cell carcinoma is an unpredictable malignancy. Sometimes, metastases are the disease debut. On the other hand, metastases could present years after treatment of the primary tumor. Four clinical cases of atypical metastases in the head and neck location are presented: parotid gland, mandibular bone, attached molar gingiva and masticator space. Physiopathology, clinics, histology and management of metastatic renal cell carcinoma at those anatomical regions are reviewed

Intraosseous dentinogenic ghost cell tumor: Case report and treatment review / Tumor dentinogénico de células fantasmas tipo central (intraóseo): un caso clínico y revisión del tratamiento

Dentinogenic ghost cell tumors (DGCT) are uncommon neoplasms classified as solid variants of calcifying odontogenic cyst and are defined as a locally invasive neoplasm, characterized by ameloblastoma-like islands of aberrant keratinization of odontogenic epithelium in the form of ghost cells in association with dysplastic dentin. We present the case of a 46-year-old woman who was referred to us due to dental mobility and swelling of the jaw. The different imaging and histological studies confirmed the diagnosis of a dentinogenic ghost cell tumor. Treatment was based on aggressive local resection with adequate safety margins, and monitoring the patient for detection of recurrences. The purpose of this paper was to describe a case of DGCT and the treatment adopted in our case, and to provide a review of the treatment of the cases reported in the indexed literature (AU)

El tumor dentinogénico de células fantasma (TDCF) es una rara neoplasia clasificada como una variante sólida del quiste odontogénico calcificante, definida como una neoplasia localmente invasiva caracterizada por la presencia de islas ameloblastomatosas con queratinización aberrante en forma de células fantasma, coexistiendo con displasia dentinaria. Presentamos un caso clínico de una paciente de 46 años que nos consultó por presentar movilidad dental con inflamación a nivel mandibular. Los estudios radiológico e histológico revelaron el diagnóstico de tumor dentinogénico de células fantasma. Se realizó resección local amplia con márgenes, revisando periódicamente a la paciente para detectar recidivas. El objetivo de este artículo es presentar un caso clínico de un TDCF, describir el tratamiento realizado en nuestro caso y revisar el tratamiento realizado en los casos publicados en la literatura indexada (AU)

Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery

The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result

Expression of hormonal receptors in osteosarcomas of the jaw bones: Clinico-pathological analysis of 21 cases

BACKGROUND: Sexual hormones have an important role in many hormone-dependant tumors like breast and prostate carcinomas, and also a relationship has been found with bone metabolism and bone tumors. Some studies have demonstrated that the expression of hormonal receptors (HR) in osteosarcomas (OS) of long bones is associd with gender, histological grade, histological type, and possibly may be connection with pathogenesis and evolution. However, to our knowledge there are no studies of HR in osteosarcomas of craniofacial bones (OS-CF).OBJECTIVES: To assess the expression of hormonal receptors in OS-CF. MATERIAL AND METHODS: Twenty one cases of OS-CF were included in this study. Clinical outcome was obtained from clinical charts. Histological sections were reviewed, and immunohistochemistry studies for estrogen, progesterone and androgen receptors were performed. RESULTS: A striking female predominance was found (2:1), with a median age of 35 years. The predominant type of OS was osteoblastic (52.4%), and histological grade was high in 86%. Follow-up was obtained in 13 cases and ranged from 6 to 118 months (median 29 months). There were 8 patients (61.5%) dead or alive with progressive disease in the last follow up. Negative expression of HR was found in 19/21 cases; one showed weak nuclear expression for estrogen receptor, and another for androgen receptor. Progesterone receptor was negative in all cases. CONCLUSIONS: OS-CF mostly affected females, most of them were of the osteoblastic type and of high grade. Hormonal expression was practically negative in osteosarcoma of craniofacial bones

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Ameloblastoma: un estudio retrospectivo de 48 casos / Ameloblastoma: a retrospective study of 48 cases

El ameloblastoma es un tumor odontogénico benigno, localmente invasivo y recidivante, que constituye aproximadamente el 11% de los tumores odontogénicos. Estos tumores ocurren más frecuentemente en la mandíbula. El cuadro clínico se caracteriza generalmente por presentar deformaciones faciales, crecimiento lento y asintomático. El tratamiento depende del tipo, la localización y el tamaño del tumor, así como de la edad del paciente. El objetivo del presente trabajo es realizar un estudio retrospectivo de los casos diagnosticados de ameloblastomas en los datos existentes de los archivos del Departamento de Patología Oral de la Pontifícia Universidade Católica de Minas Gerais, Brasil. Se analizaron los archivos de pacientes en el periodo de enero de 1978 a marzo de 2012, con un diagnóstico definitivo de ameloblastoma. Método. Fueron analizadas las informaciones con respecto a sexo, raza, edad del paciente, presencia de síntomas, aspecto radiográfico del tumor, diagnóstico histopatológico y ubicación anatómica. Resultados. Dentro de los 48 pacientes con ameloblastoma se observó mayor incidencia en la mandíbula en la zona del cuerpo y ángulo (45,8%), que afecta por igual a hombres y mujeres, con un promedio de edad de 36 años y en su gran mayoría se mostraron asintomáticos (81,2%). El tipo más frecuente fue el multiquístico (66,7%), seguido por el uniquístico (31,2%) y el periférico (2,1%). La mayoría de lesiones fueron observadas en la raza blanca (56,3%) y radiográficamente se mostró más frecuente la imagen multilocular (60,4%). Conclusión. Los datos de los ameloblastomas reportados en este estudio fueron similares a los de otras series publicadas en la literatura médica (AU)

Ameloblastoma is a benign, locally invasive and recurrent, odontogenic tumor, which accounts for about 11% of odontogenic tumors. These tumors occur more frequently in the mandible. The clinical picture presented is generally characterized by slow growing and asymptomatic facial deformities. Treatment depends on the type, location and size of the tumor, as well as the age of the patient. The aim of this paper is to present a retrospective study of diagnosed cases of ameloblastoma in existing data files of the Department of Oral Pathology Catholic University of Minas Gerais, Brazil. Data was collected from the files of patients with a definitive diagnosis of ameloblastoma during the period January 1978 to February 2012. Method: An analysis was made of the data, including sex, race, patient age, symptoms, radiographic appearance of the tumor, the histopathological diagnosis and anatomic location. Results: Of the 48 patients with ameloblastoma there was an increased incidence in the jaw and the angle (45.8%). It affected both men and women, with a mean age of 36 years, and the large majority were asymptomatic (81.2%). The most frequent histological type was multicystic (66.7%), followed by unicystic (31.2%), and peripheral (2.1%). Most lesions were observed in white people (56.3%) and radiographically, it was more often a multilocular image (60.4%). Conclusion: The data reported in this study of ameloblastomas were similar to other series reported in the medical literature (AU)

Ameloblastoma, a rare benign odontogenic tumour: an interesting tumour review targeting the role of radiation therapy

Ameloblastoma is known as a benign, slow-growing, rare, odontogenic neoplasm. The solid/multicystic, the unicystic with a fibrous connective-tissue capsule and the peripheral ameloblastoma represent the three well distinguished clinical types of ameloblastoma. Surgical resection with an attempt to achieve adequate free margins constitutes a well documented and accepted treatment modality. Controversies exist, however, with regard to the extent of operative intervention. Patients with inadequate or positive surgical margins or unresectable lesions can be treated with radiation or combined radiation and chemotherapy. The authors present a review of this sparse disease focusing on the special role and efficacy of radiation therapy in its management (AU)

Cavidad ósea idiopática de Stafne. Diagnóstico y manejo / Stafne idiopathic bone cavity. Diagnosis and management

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Retrospective clinicopathological study of 418 odontogenic cysts

Objectives: To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona(Spain).Study design: A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables,using the SPSS version 15.0.Results: The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm,with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%).Conclusions: The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to beslightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment (AU)

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Multiple brown tumours of tertiary hyperparathyroidism in a renaltransplant recipient: A case report

Tertiary Hyperparathyroidism (HPT) is an uncommon condition that affects patients with secondary HPT aftera successful kidney transplant. Bone alterations are the main consequences of this endocrine condition, includingthe development of an osteolytic lesion called brown tumour. This paper reports an unusual case of multiplebrown tumours located in the maxilla and mandible in a 58-year-old renal transplant recipient, with tertiary HPT.Incisional biopsies were performed and, in both samples, the histopathological diagnoses were giant cell lesions.Due to these diagnoses, the medical history of chronic renal failure, and high levels of serum calcium and PTH,lesions were diagnosed as multiple brown tumours of tertiary HPT. The lesions showed regression within the twomonths following a total parathyroidectomy. Minimal local interventions were established to make an early diagnosisand to treat these lesions. The diagnosis of primary oral lesions was very important in order to demonstratethe relevance of interdisciplinary activity and the inclusion of dentists as part of organ transplant units (AU)

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El posible verdadero origen de la metodología transfacial / The real origin of transfacial methodology

Siempre surgen, pese a los adelantos informáticos de un mundocada vez más globalizado, conflictos sobre la autoría de procedimientos científicosy para ayudar a aclarar los que ocurren en el origen de la cirugía transfacial,es por lo que nos hemos entretenido siempre con apoyo bibliográfico,de poner orden, en los aspectos no sólo del posible verdadero origen yla autoría de esta tal como se entiende hoy día, sin olvidar a personalidadeshistóricas que en el siglo XIX vislumbraron y cómo no, aportaron ideas de loque podría venir y sobre todo, quien dejo escrito por primera vez el contenidoy las verdaderas posibilidades de la misma, así como poner en su sitioa los que se incorporaron al procedimiento muy tarde con pretensiones deprotagonismo(AU)

Despite technological advances in a globalized worldconflicts always arise about authorship of scientific procedures. Tohelp resolve the conflicts that arise about the origin of transfacialsurgery we have been entertained with bibliographical support toorganize the aspects of a possible origin and author as it isunderstood today. Without forgetting people in history that in theXIX century foreshadowed and provided ideas from which we coulddetermine who was the first to write the content and true possibilities.Putting those who incorporated the procedure late, with pretensionsof protagonism in their place(AU)

Síndrome del mentón entumecido. A propósito de un caso / The Numb Chin syndrome: a clinical case

El Síndrome del mentón entumecido o neuralgia mandibula maligna es un cuadro poco conocido por el odontólogo general pero con el que están bastante familiarizados los especialistas en Oncología. El paciente afecto presenta, dentro de un cuadro oncológico, un entumecimiento uni o bilateral de las áreas inervadas por los nervios mentonianos, sin relación, en muchos casos, con una tumoración a ese nivel. Presentamos un caso de un varón de 82 años que padecía, en noviembre de 2005, un cuadro febril leve y anestesia en el territorio inervado por el mentoniano derecho y un molar 46 con tratamiento de conductos obturados años atrás. Tras múltiples estudios, resultó padecer un cáncer pulmonar con diseminación ósea en el que, hasta su fallecimiento (mayo- 2008) no se puedo constatar masa tumoral en el territorio mandibular. Por otro lado, el tratamiento de los cánceres metastáticos o primitivamente óseos con bisfosfonatos I. V que pueden provocar osteonecrosis, aún pueden confundir más a la hora de llegar a un correcto diagnóstico del dolor o entumecimiento maxilar (AU)

The Numb Chin Syndrome o Malignat mentoniana neuropathy is a disease quite unknown by the general dentist but familiar to specialist in oncology. The patients present a uni-or-bilateral numbness of the areas innervated by the mentonian nerves, symptom which is not usually related with tumors in this area. We report a case of a man who suffered since he was 82 years old, in November of 2005, a mild fever and anesthesia in the area innervated by the right mentonian nerve. He also presented an endodontic treatment of the first lower right molar. After multiple studies the patient was diagnosed from a lung cancer which had spread to the bones, in which, until his death in May of 2008 we did not observe a tumor in the jaw area. On the other hand, the treatment of metastatic cancers with bisphosphonates I. V. can cause osteonecrosis, which can make difficult a correct diagnosis of jaw pain or numbness. In the case we find a combined presence of osteonecrosis for this reason and pain and numbness of the same area (AU)