Correlation between the anatomical morphology of palatal rugae and sex / Correlación entre la morfología anatómica de las rugas palatinas y el sexo

SUMMARY: To investigate the correlation between the anatomical morphology of palatal rugae and sex. The study sample consisted of 120 students studying from Shanxi Medical University, of which 60 were females and 60 were males. The digital model of the palatal rugae was obtained by the 3 Shape TRIOS intraoral scanner. And the shapes of palatal rugae were recorded. Association between palatal rugae shape and sex were tested using Chi-square analysis. And logistic regression analysis (LRA) was carried out to calculate the accuracy of gender prediction using rugae shapes. There was a statistically significant difference between males and females in terms of the distribution of wavy and circular palate rugae. The use of logistic regression analysis obtained a sex predictive value of 65 % when all the rugae shapes were analyzed. Digital images of the palatal rugae morphology contribute to more accurate and convenient for data collection and transformation. It was found that rugae patterns can moderately identify the sex of the specific population when multivariate statistics such as LRA is applied. The palatal rugae morphology can be utilized as an assistant measure for sex identification.

RESUMEN: Investigar la correlación entre la morfología anatómica de las rugas palatinas y el sexo. En la muestra de este estudio se incluyeron 120 estudiantes de la Universidad Médica de Shanxi, (60 mujeres y 60 hombres). El modelo digital de las rugas palatinas se obtuvo mediante escáner intraoral 3 Shape TRIOS, y se registraron las formas de las rugas palatinas. La asociación entre la forma de las rugas palatinas y el sexo se evaluó mediante un análisis de Chi-cuadrado; para calcular la precisión de la predicción de sexo se llevó a cabo un análisis de regresión logística (ARL) Se observó una diferencia estadísticamente significativa entre hombres y mujeres en términos de la distribución de las rugas palatinas onduladas y circulares. El uso de análisis de regresión logística obtuvo un valor predictivo de sexo del 65 % cuando se analizaron todas las formas de las rugas. Las imágenes digitales de la morfología de las rugas palatinas contribuyen a una recopilación de datos más precisa. En este análisis se determinó que los patrones de rugas pueden identificar relativamente el sexo de una población específica, cuando se aplican estadísticas multivariadas como ARL. La morfología de las rugas palatinas se puede utilizar como medida de ayuda para la identificación de sexo.

Adenoma pleomórfico em palato duro: relato de caso / Pleomorphic adenoma in hard palate: case report / Adenoma pleomórfico en paladar duro: reporte de caso

Introdução: O adenoma pleomórfico (AP) é a neoplasia de glândula salivar mais comum e se apresenta como um aumento de superfície firme, indolor e com crescimento lento. O palato, a cavidade nasal e a nasofaringe são áreas em que se localizam muitas glândulas salivares menores, sendo o adenoma pleomórfico, o tumor benigno mais comum nessas glândulas. O AP pode acometer indivíduos em qualquer faixa etária, principalmente na terceira e quarta década de vida, com predominância pelo gênero feminino. O artigo objetiva relatar um caso clínico de adenoma pleomórfico em palato duro, comparando com dados presentes na literatura especializada em relação, especialmente, aos sítios acometidos e as formas de tratamentos existentes. Relato de caso: Paciente do sexo feminino, 34 anos, compareceu ao ambulatório do HU-Univasf com queixa de aumento de volume indolor em boca há 02 anos. Foi realizada uma biópsia incisional onde no exame histopatológico foi diagnosticado como Adenoma Pleomórfico. O tratamento eleito foi a excisão cirúrgica e uso de placa de polimetilmetacrilato no pós-operatório. Atualmente o paciente apresenta follow up de 02 anos e 05 meses, sem sinais de recidiva da lesão e sem queixas locais... (AU)

Introduction: Pleomorphic adenoma (PA) is a more common salivary gland neoplasia and presents as an increase in firm, painless and slow-growing surface. The palate, a nasal cavity and a nasopharynx, are areas that locate many minor salivary glands, being pleomorphic adenoma, the most com mon benign tumor in these glands. The PA can affect individuals in any age group, mainly in the third and fourth decade of life, with a predominance in a females. The article aims relates a clinical case of pleomorphic adeno ma on the hard palate, comparing it with the data present in the specialized literature in relation, especially, to the affected locations and the ways to ex isting treatments. Case Report: A 34 years old, female patient, showed up to the HU-Univasf outpatient clinic with a complaint of an increase in vol ume painless in the mouth for 2 years. An incisional biopsy was performed in which the histopathological examination was diagnosed as Pleomorphic Adenoma. The treatment chosen was surgical excision and use of polymeth ylmethacrylate plate. Currently, the patient has a follow-up of 02 years and 05 months, with no signs of recurrence of the lesion and no local complaints... (AU)

Introducción: El adenoma pleomórfico (AP) es la neoplasia de glándulas salivales más común y se presenta como un agrandamiento firme, indoloro y de crecimiento lento. El paladar, la cavidad nasal y la nasofaringe son áreas en las que se localizan muchas glándulas salivales menores, siendo el adenoma pleomórfico el tumor benigno más común en estas glándulas. La AF puede afectar a individuos de cualquier grupo de edad, especialmente en la tercera y cuarta década de la vida, con predominio del sexo femenino. El artículo tiene como objetivo reportar un caso clínico de adenoma pleomórfico en paladar duro, comparándolo con datos de la literatura especializada en relación, especialmente, con los sitios afectados y las formas de tratamiento existentes. Caso clínico: Paciente de sexo femenino de 34 años que acudió a la consulta externa de HU-Univasf quejándose de hinchazón bucal indolora durante 02 años. Se realizó biopsia incisional y el examen histopatológico se diagnosticó como adenoma pleomórfico. El tratamiento elegido fue la exéresis quirúrgica y el uso postoperatorio de placa de polimetilmetacrilato. Actualmente, el paciente tiene un período de seguimiento de 02 años y 05 meses, sin signos de recurrencia de la lesión y sin quejas locales... (AU)

Morphometric study of incisive, greater and lesser palatine foramina: a novel point of maxillary nerve block in a Thai population / Estudio morfométrico del foramen palatino incisivo, mayor y menor: un punto novedoso de bloqueo del nervio maxilar en una población tailandesa

SUMMARY: To study the morphometric location of the incisive, greater, and lesser palatine foramina for maxillary nerve block. Two hundred Thai dry skulls were randomly organized from the Forensic Osteology Research Center. The distances of the parameters were measured via Vernier caliper.: Thedistances from the incisive foramen to the incisive margin of the premaxilla were 10.93?2.42 mm in males and 10.98?2.06 mm in females. From the left side, the incisive foramen to the greater palatine foramen (GPF) was39.07?2.23mm in males and 38.57?2.41 mm in females, and from the right side were 39.81?2.37 mm in males and 38.62?2.53mm in females. From the left side, the incisive foramen to the lesser palatine foramen (LPF) was 43.16?2.23 mm in males and 41.84?2.42mm in females and from the right side were 42.93?2.14 mm in males and 41.76?2.61 mm in females. The GPF found at medial to the maxillary third molar were 94-95 % in males and 84 % in females. These findings suggest that the medial position to the third molar teeth be used as a landmark for a palatine nerve block in Thais. These findings will help dentists to perform local anesthetic procedures, especially the nasopalatine and greater palatine nerve blocks, more effectively.

RESUMEN: El objetivo de este trabajo fue estudiar la localización morfométrica de los forámenes palatinos incisivos, mayores y menores para el bloqueo del nervio maxilar. Se organizaron al azar doscientos cráneos secos tailandeses del Centro de Investigación de Osteología Forense. Las distancias de los parámetros se midieron mediante un calibre Vernier. Las distancias desde el foramen incisivo hasta el margen incisivo de la premaxila fueron 10,93 ? 2,42 mm en hombres y 10,98 ? 2,06 mm en mujeres. Desde el lado izquierdo, el foramen incisivo al foramen palatino mayor (FPM) fue de 39,07 ? 2,23 mm en los hombres y 38,57 ? 2,41 mm en las mujeres, y del lado derecho fue de 39,81 ? 2,37 mm en los hombres y 38,62 ? 2,53 mm en las mujeres. Del lado izquierdo, el foramen incisivo al foramen palatino menor (LPF) fue de 43,16 ? 2,23 mm en hombres y 41,84 ? 2,42 mm en mujeres y del lado derecho 42,93 ? 2,14 mm en hombres y 41,76 ? 2,61 mm en mujeres. El FPM encontrado medial al tercer molar maxilar fue 94-95 % en hombres y 84 % en mujeres. Estos hallazgos sugieren que la posición medial de los terceros molares se utilice como punto de referencia para un bloqueo del nervio palatino en individuos tailandeses. Estos hallazgos ayudarán, de manera más eficaz, a los dentistas a realizar procedimientos anestésicos locales, especialmente los bloqueos nasopalatinos y del nervio palatino mayor.

Cisto do ducto nasopalatino: relato de caso / Nasopalatine duct cyst: case report

Introdução: O cisto do ducto nasopalatino é uma lesão não odontogênica com etiologia controversa. No entanto, fatores irritantes, como trauma local e infecções bacterianas, podem estimular o remanescente epitelial do ducto nasopalatino, levando a uma formação cística. Sua predileção ocorre em homens adultos entre a quarta e a sexta décadas. Geralmente é assintomático, sendo detectado por exame de rotina. O objetivo do presente estudo é apresentar e discutir um caso de cisto do Ducto Nasopalatino, analisando-se os aspectos clínicos e imaginológicos da patologia em face, comparando-o com dados provenientes da literatura corrente. Relato de caso: Como resultado este artigo apresenta a abordagem de um caso cirúrgico de cisto do Ducto Nasopalatino em face, assintomático, descoberto em exame imaginológico de rotina, biopsiado e enucleado cirurgicamente, com acompanhamento de 5 anos sem recidiva. Considerações finais: É evidente, portanto, que a literatura ainda não é unânime quanto ao aspecto epidemiológico, contudo, se reafirma a forma de abordagem cirúrgica excisional como tratamento eficaz definitivo. Faz-se necessária, portanto, a análise clínica, imaginológica e histopatológica para a confirmação diagnóstica da lesão. A observação de tais aspectos é de fundamental importância para um tratamento eficaz e definitivo, reduzindo as chances de recidiva... (AU)

Introduction: The nasopalatine duct cyst is a non-odontogenic lesion with controversial etiology. However, irritating factors, such as local trauma and bacterial infections, can stimulate the epithelial remnant of the nasopalatine duct, leading to a cystic formation. Its predilection occurs in adult men between the fourth and sixth decades. It is usually asymptomatic, being detected by routine examination. Objectives: To present and discuss a case of cyst of the Nasopalatine duct, analyzing the clinical and imaging aspects of the pathology in the face, comparing it with data from the current literature. Case Report: As a result, this article presents the approach of a surgical case of Nasopalatine Ducto cyst in the face, asymptomatic, discovered in a routine imaging exam, biopsied and surgically enucleated, with a 5-year follow-up without recurrence. Final considerations: It is evident, therefore, that the literature is not yet unanimous in terms of the epidemiological aspect, however, the form of excisional surgical approach as a definitive effective treatment is reaffirmed. Therefore, clinical, imaging and histopathological analysis is necessary to confirm the diagnosis of the lesion. The observation of such aspects is of fundamental importance for an effective and definitive treatment, reducing the chances of recurrence... (AU)

Relación morfológica entre el hueso hioides y el viscerocráneo en una muestra de esqueletos / Morphologic relationship between the hyoid bone and the viscerocranium in a sample of skeletons

Introducción: El movimiento corporal, obedece y produce actividad del músculo esquelético para lo cual debe existir un equilibrio muscular estático, a partir del cual se genere el desplazamiento de los elementos anatómicos, involucrados en él, ya sea como respuesta a la volición o a la percepción inconsciente al estímulo que lo demande. Objetivo: Asociar el comportamiento morfológico del hioides con ciertas variables morfológicas del viscerocráneo de esqueletos (excepto la mandíbula). Material y Métodos: Se realizó estudio osteológico en una muestra ósea de 82 esqueletos mediante mediciones morfométricas del hueso hioides y huesos del viscerocráneo. Se utilizaron matrices de coeficiente de correlación lineal de Pearson en SPSS 22 para evaluar la relación de la morfología del hioides con respecto a la morfología de los huesos de la cara. Variables morfológicas del viscerocráneo como ancho bicigomático (abc), ancho transversal externo del paladar óseo (pote), ancho sagital externo del paladar óseo (pose) y la altura del tercio medio de la cara (tmed). Resultados: Se obtuvo una gran correlación positiva y significativa de distintas variables morfológicas del hioides, -tanto de su cuerpo como de sus astas o cuernos mayores- con las variables morfológicas del viscerocráneo. Conclusiones: Se corrobora la asociación de la morfología del hueso hioides con el crecimiento de los huesos del viscerocráneo(AU)

Introduction: Body movement obeys and produces activity in the skeletal muscle for which there must be a static muscle equilibrium that produces the movement of the anatomic elements involved in it, either as a result of volition or as the unconscious perception of a stimulus. Objective: To associate the morphological behavior of the hyoid bone with some morphological variables of the viscerocranium of skeletons (except the jaw). Material and Methods: An osteological study was carried out in a bone sample of 82 skulls by performing morphometric measurements of the hyoid bone and the bones of the viscerocranium. Pearson's correlation coefficient and SPSS Version 22 were used to evaluate the relationship between the morphology of the hyoid bone and the facial bones. Morphological variables of the viscerocranium include: bizygomatic width (BW), external transverse width of the hard palate (ETWHP), external sagittal width of the hard palate (ESWHP), and the height of the middle third of the face (MTF). Results: A very strong positive correlation between different morphological variables of the hyoid bone, -both at the level of its antlers or greater horns- and the morphological variables of the viscerocranium was obtained. Conclusions: These findings corroborate the association between the hyoid bone and the growth of facial bones(AU)

Diferencias morfométricas en el hueso palatino de la oveja (Ovis aries) y la cabra (Capra hircus) / Morphometric palatine differences between sheep (Ovis aries) and goat (Capra hircus)

RESUMEN: Un hueso craneal muy poco estudiado en anatomía veterinaria comparada es el palatino. En nuestro estudio, realizamos la comparación de este hueso entre la oveja (Ovis aries L., 1758) y la cabra (Capra hircus L., 1758), a partir de una muestra de 36 y 17 cráneos respectivamente, y utilizando métodos de morfometría geométrica. Se eligieron un total de 32 puntos (4 hitos y 28 semi-hitos) para analizar la lámina horizontal del hueso palatino. Se reflejaron diferencias estadísticamente significativas tanto para el tamaño como para la forma. En Capra se denota una clara expansión lateral del hueso y rostral y una contracción central, con un acercamiento relativo de los forámenes palatinos, mientras que en Ovis los forámenes están más lateralmente alejados. A nuestro parecer, esta mayor anchura y longitud de la lámina horizontal en Capra se explicaría por una mayor capacidad de frotación del alimento en relación a Ovis.

SUMMARY: Palatine is a cranial bone very less studied in comparative veterinary anatomy. In our study, we performed the comparison of this bone between sheep (Ovis aries L., 1758) and goat (Capra hircus L., 1758), from a sample of 36 and 17 skulls respectively, using methods of geometric morphology. A total of 32 points (4 landmarks and 28 semi-landmarks) were chosen to analyse the horizontal lamina of the palatine bone. Statistically significant differences were reflected for both size and shape. Capra denotes a clear lateral expansion of the bone and rostral and a central contraction, with a relative approach of palatine foramina, while in Ovis foramina are more laterally distant. In our view, this greater width of the horizontal lamina in Capra would be explained by a greater capacity to rub the food compared to Ovis.

Evaluation of oral stereognosis in completely edentulous patients with palatal tori / Evaluación de la estereognosia oral en pacientes completamente edéntulos con toros palatinos

Background: The corollary is not investigated in the completely edentulous patients with palatal tori. Objective: The aim of this study was to assess the oral stereognostic ability in completely edentulous patients with palatal tori. Material and Methods: Thirty-four completely edentulous patients aged 50 to 89 years were allocated to Group 1 (without palatal tori, n=18) and Group 2 (with palatal tori, n=16). The oral stereognostic test was conducted using 6 intraoral test pieces (circle/square/rectangle/triangle/plus/toroid) that were fabricated to standard dimensions using the light cure acrylic resin. Each test piece was placed in the patient's mouth and was asked to manipulate the test piece between the tongue and the palate. The patients identified the shapes by matching them on a shape chart. Each correct identification was assigned a score of 1. The response time taken to identify each shape was recorded. Statistical computation was done using a chi - square test and Mann-Whitney U test. Results: Significant difference was observed in the overall scoring percentages between the 2 groups (p<0.05). Group 2 had lower oral stereognostic scores compared to group 1 (p<0.05). There was no statistically significant difference in the mean response time for identifying the shapes among the groups, however group 2 patients had longer response time. Conclusion: Oral stereognostic ability of the completely edentulous patients with torus palatinus was lower when compared to completely edentulous patients without tori.

Antecedentes: el corolario no se investiga en los pacientes completamente desdentados con toros palatinos. Objetivo:El objetivo de este estudio fue evaluar la capacidad estereognóstica oral en pacientes completamente edéntulos con toros palatinos. Material y Métodos: Treinta y cuatro pacientes completamente edéntulos de 50 a 89 años fueron asignados al Grupo 1 (sin toros palatinos, n = 18) y al Grupo 2 (con toros palatinos, n = 16). La prueba estereognóstica oral se realizó utilizando 6 piezas de prueba intraorales (círculo / cuadrado / rectángulo / triángulo / cruz / aro) que se fabricaron a dimensiones estándar utilizando la resina acrílica fotopolimerizable. Cada pieza de prueba se colocó en la boca del paciente y se le pidió que manipulara la pieza de prueba entre la lengua y el paladar. Los pacientes identificaron las formas haciéndolas coincidir en un gráfico de formas. A cada identificación correcta se le asignó una puntuación de 1. Se registró el tiempo de respuesta necesario para identificar cada forma. El cálculo estadístico se realizó mediante la prueba de chi-cuadrado y la prueba U de Mann-Whitney. Resultados: Se observó una diferencia significativa en los porcentajes de puntuación generales entre los 2 grupos (p<0,05). El grupo 2 tuvo puntuaciones estereognósticas orales más bajas en comparación con el grupo 1 (p<0,05). No hubo diferencia estadísticamente significativa en el tiempo medio de respuesta para identificar las formas entre los grupos, sin embargo, los pacientes del grupo 2 tuvieron un tiempo de respuesta más largo.Conclusión: La capacidad estereognóstica oral de los pacientes completamente edéntulos con torus palatino fue menor en comparación con los pacientes completamente edéntulos sin torus.

Osteosarcoma of the hard palate in a dog - case report / [Osteossarcoma em palato duro de cão - relato de caso]

The osteosarcoma (OSA) is the most diagnosed primary bone cancer in canine patients. This work reports a case of a canine, six years old, mongrel, female, intact, with an OSA in the hard palate. Physical examination detected a firm mass in the palate. Thoracic radiographs, hematological and biochemical exams, histopathological exams and computed tomography were requested. A chondroblastic OSA was diagnosed and the tumor was characterized by immunohistochemistry. There was never evidence of metastasis in this case. The treatment consisted of the combination of conventional chemotherapy, metronomic chemotherapy, and palliative care, aiming at greater survival and well-being of the patient since surgical excision was not possible due to the location and extension of the tumor. Osteogenic sarcomas of the hard palate are rarely seen and described in the literature. In this article we present a characterization of the osteosarcoma with uncommon localization in the hard palate.(AU)

O osteossarcoma (OSA) é a neoplasia óssea primária mais diagnosticada em pacientes caninos. Este trabalho relata o caso de um canino, com seis anos de idade, sem raça definida, fêmea, não castrado, apresentando OSA em região de palato duro. Ao exame clínico, constatou-se uma massa de consistência firme em região palatina. Além do exame clínico, foram solicitadas radiografias torácicas, exames hematológicos e bioquímicos, exames histopatológicos e tomografia computadorizada. Fora então dado o diagnóstico de OSA condroblástico, e o tumor foi caracterizado pela imuno-histoquímica. Não foram observadas evidências de metástases nesse caso. O tratamento instituído consistiu na combinação de quimioterapia convencional, quimioterapia metronômica e cuidados paliativos, almejando maior sobrevida e bem-estar do paciente, uma vez que a excisão cirúrgica não foi possível devido à localização e à extensão do tumor. Neste artigo, apresentou-se uma caracterização do osteossarcoma com localização incomum no palato duro.(AU)

Non-ulcerated necrotizing sialometaplasia may mimic a salivary gland tumor

Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory entity that mainly affects the minor salivary glands located in the hard palate. Classically, NS is characterized as a nodule that evolves to a central ulcer. The most widely recognized triggering factor is an ischemic event. The diagnosis becomes a challenge in non-ulcerated NS cases which is essential to rule out the possibility of salivary gland tumors, especially the malignant ones. Here, we presented a case of a 32-year-old male patient with a 1-month complaint of a painful, slightly elevated erythematous area on the hard palate. Incisional biopsy was performed, and NS was diagnosed based on histopathological and immunohistochemical analyses. Clinicians should be aware of and consider NS as a differential diagnosis of minor salivary gland tumors, particularly when it presents as a non-ulcerated clinical aspect.

A Foreign Body in Infant Palate: A Case Report

ABSTRACT This report aims to discuss the occurrence and differential diagnosis in hard palate foreign bodies in infants. We present the case of a 16-month-old girl who was found to have plastic part of a toy embedded in her hard palate as a foreign body. The foreign body was extracted with care to avoid aspiration. The possibilities of misdiagnosis and airway aspiration are discussed. Great care was focused on the prevention of airway aspiration.

Fotobiomodulação associada à escleroterapia no tratamento de hemangioma em palato duro / Photobiomodulation associated with sclerotherapy for treatment of hemangioma in the hard palate

Resumo As alterações vasculares ocorrem frequentemente em região de cabeça e pescoço, sendo o hemangioma a mais comum. Paciente do sexo feminino, 61 anos, queixou-se de dor intensa em palato duro. Notou-se lesão arroxeada, de 1,5 cm, sensível à palpação e com histórico de hemorragia. A paciente era edêntula total, e a prótese total superior comprimia o local da lesão. Foi realizada a vitropressão, confirmando a origem vascular. A hipótese diagnóstica foi de hemangioma. Na primeira sessão, aplicou-se o laser vermelho (660 nm) em quatro pontos ao redor da lesão, sendo 0,5 J em cada ponto afim de se obter analgesia e iniciar o processo de reparo, além do reembasamento da prótese total superior. Na segunda sessão, foi feita aplicação de 2 mL de oleato de monoetanolamina 5%. Após 14 dias, observou-se regressão total da lesão. Os cirurgiões-dentistas devem estar aptos a reconhecer, diagnosticar e tratar as lesões vasculares em cavidade oral.

Abstract Vascular changes frequently involve the head and neck region and hemagioma is the most common. A 61-year-old female patient complained of severe pain in the hard palate. A purple lesion was found, measuring 1.5 cm, sensitive to palpation, and with a history of hemorrhage. The patient was fully edentulous and her upper denture compressed the lesion site. Diascopy confirmed the lesion's vascular origin. A diagnostic hypothesis of hemangioma was raised. In the first session, red laser light (660nm) was applied at 4 points around the lesion, with 0.5 J at each point, in order to obtain analgesia and trigger the repair process. The upper denture was also relined. In the second session, 2 mL of 5% monoethanolamine oleate was applied. After 14 days, total regression of the lesion was observed. Dental surgeons must be able to recognize, diagnose and treat vascular lesions in the oral cavity.

Determinación de factores relacionados al desarrollo de fístulas palatinas posterior a una palatoplastia primaria / Determination of factors related to the development of palatal fistula after a primary palatoplasty

INTRODUCCION. La fistula palatina es la persistencia de comunicación anormal entre la cavidad nasal y oral post palatoplastia, es la complicación frecuente con: alta morbilidad, problemas para la alimentación, articulación de las palabras inapropiada, halitosis hasta problemas psicosociales como baja autoestima y rechazo social. OBJETIVO. Determinar los factores asociados al desarrollo de fístula palatina. MATERIALES Y MÉTODOS. Estudio observacional, analítico de casos y controles. De una población de 334 Historias Clínicas se tomó muestra de 89 en la Unidad de Plástica y Reconstructiva del Hospital de Especialidades Carlos Andrade Marín de enero 2010 a julio 2019. Criterios de inclusión: datos de pacientes con paladar fisurado reparado por palatoplastia. Criterios de Exclusión: pacientes sin buen seguimiento postquirúrgico y con paladar hendido sin reparación quirúrgica. Los datos fueron obtenidos del sistema AS400, el análisis se realizó mediante el programa estadístico International Business Machines Statistical Package for the Social Sciences. RESULTADOS. El uso de ortopedia prequirúrgica (OR: 0,014; p<0,000) y la alimentación con leche materna (OR: 0,033; p<0,003) fueron factores protectores. DISCUSIÓN. La ortopedia prequirúrgica fue la mejor opción de moldeamiento en pacientes con hendiduras amplias para la aproximación de los segmentos óseos hendidos, como factor protector significativo se encontró a la lactancia materna exclusiva dato que coincide con el estudio de López YD., donde mencionó que produjo mayor estimulación para la fusión de las crestas palatinas a pesar de que no fue estadísticamente significativa. CONCLUSION. Los factores asociados al desarrollo de fístula palatina estadísticamente significativos fueron el uso de ortopedia prequirúrgica y la alimentación con leche materna, catalogados como protectores.

INTRODUCTION. Palatal fistula is the persistence of abnormal communication between the nasal and oral cavity post palatoplasty, it ́s the frequent complication with: high morbidity, feeding problems, inappropriate articulation of words, halitosis and psychosocial problems such as low self-esteem and social rejection. OBJECTIVE. Determine the factors associated with the development of palatal fistula. MATERIALS AND METHODS. Observational, analytical case-control study. From a population of 334 Clinical Histories, a sample of 89 was taken in the Plastic and Reconstructive Unit of the Carlos Andrade Marín Specialty Hospital from january 2010 to july 2019. Inclusion criteria: data from patients with cleft palate repaired by palatoplasty. Exclusion Criteria: patients without good postsurgical follow-up and with a cleft palate without surgical repair. The data were obtained from the AS400 system, the analysis was performed using the International Business Machines Statistical Package for the Social Sciences statistical program. RESULTS. The use of presurgical orthopedics (OR: 0,014; p<0,000) and feeding with breast milk (OR: 0,033; p<0,003) were protective factors. DISCUSSION. Presurgical orthopedics was the best molding option in patients with wide clefts for the approximation of the cleft bone segments, as a significant protective factor, exclusive breastfeeding was found, data that coincides with the study by López YD., where he mentioned that it produced greater stimulation for palatine ridge fusion although it was not statistically significant. CONCLUSION. Statistically significant factors associated with the development of palatal fistula were the use of pre-surgical orthopedics and feeding with breast milk, classified as protective.

Dimorfismo sexual a través del análisis morfométrico de bóvedas palatinas en una población peruana / Sexual Dimorphism Via Palatal Vault Morphometric Analysis on A Sample Peruvian Population

Resumen: Objetivo: Determinar la precisión del dimorfismo sexual a través del análisis morfométrico de bóvedas palatinas en cráneos procedentes del Laboratorio de Investigación Forense del Equipo Forense Especializado (EFE) de Ayacucho del Ministerio Público - Perú. Materiales y métodos: Diseño transversal, constituido con una muestra de 43 cráneos con sexo biológico preestablecido, (24=masculino y 19=femenino). La estimación del dimorfismo sexual se estableció a través del método propuesto por Meera Jacob y cols., basado en las mediciones de la longitud y ancho palatino, posteriormente se calculó el índice palatino, estableciéndose la precisión y exactitud del método. El análisis inferencial se realizó con un nivel de significancia del 5% a través de la prueba T student, Shapiro Wilk y el coeficiente de Pearson. Resultados: Se estableció que el ancho palatino presenta una media de 3,43 (+0,31) cm. para el sexo masculino y 3,62 (+0,25) cm. para el femenino, en la longitud palatina la media fue de 5,07 (+0,44) cm. para masculino y 4,79 (+0,41) cm. en el femenino; en el índice palatino, el 100% de los cráneos de sexo masculino corresponden al paladar duro estrecho y en el femenino un 73,7% al estrecho, un 21% al intermedio y un 5,3% al ancho. Además, se determinó que existió diferencias estadísticamente significativas entre los parámetros del ancho y longitud de la bóveda palatina entre ambos sexos y se planteó una fórmula de análisis discriminante. Conclusión: El análisis morfométrico de bóvedas palatinas establece una precisión de 83.72% en la estimación del dimorfismo sexual.

Abstracts: Objective: Determine sexual dimorphism precision via palatal vault morphometric analysis in craniums sourced from the Laboratorio de Investigación Forense del Equipo Forense Especializado (EFE) de Ayacucho del Ministerio Público- Perú. Materials and Methods: Cross-sectional design consisting of a sample of 43 skulls with pre-established biological gender, (24 males and 19 females). Sexual dimorphism was established by means of the method proposed by Meera Jacob and co., based on palatal width and length measurements, after which the palatal index was calculated, establishing the method's precision and accuracy. The inferential analysis was made with a level of significance of 5% through the T student test, Shapiro Wilk and Pearson's coefficient. Results: Palatal width had a mean of 3.43 (+0.31cm) for males and 3.62 (+0.25) for females and in palatal length a mean of 5.07 (+0.44) cm. for males and 4.79 (+0.41) cm. for females is established; on palatal index, 100% of the male skulls correspond to hard narrow palate and on females 73.7% to narrow, 21% to intermediate and 5.3% to wide. Furthermore, it was determined that there were statistically significant differences between width and length of palatal vault for both genders, and a discriminating analysis formula was proposed. Conclusion: Morphometric analyses of palatal vaults establish an 83.72% precision on the estimation of sexual dimorphism.

Perforación de la bóveda palatina por consumo de cocaína: reporte de un caso / Perforation of the palatine dome for cocaine consumption: report of a case

El abuso del consumo de cocaína puede ocasionar problemas físicos y mentales graves. Dicha droga puede ser utilizada de varias formas y sus efectos sobre la cavidad oral varían según la vía de administración, causando desde erosiones en las piezas dentarias, abrasiones cervicales, caries, enfermedad periodontal, disfunción temporomandibular, xerostomía, ulceraciones hasta la perforación del paladar duro y/o blando. Se describirá el caso clínico de un paciente cocainómano que concurrió al servicio de odontología del Hospital San Martin de La Plata, presentando dos perforaciones en el paladar duro debido al consumo crónico, y el tratamiento de urgencia correspondiente mediante una placa obturatríz que favorece la deglución y el habla del paciente (AU)

Abuse of cocaine use can cause serious physical and mental problems. is drug can be used in several ways and its effects on the oral cavity vary according to the route of administration, causing from erosions in the teeth, cervical abrasions, caries, periodontal disease, temporomandibular dysfunction, xerostomia, ulcerations to the perforation of the hard palate and / or soft.The clinical case of a cocaine patient who attended the dentistry service of the San Martin de La Plata Hospital will be described, presenting two perforations in the hard palate due to chronic consumption, and the corresponding emergency treatment by means of an obturator plate that favors swallowing and He speaks of the patient (AU)

Exérese de extenso tórus palatino: relato de caso / Excision of extensive palatine torus: case report

Introdução: O tórus palatino se caracteriza por um desenvolvimento ósseo não patológico que ocorre ao longo da linha média do palato duro. Possui etiologia relacionada a fatores genéticos e ambientais, sendo a exostose mais comum em cavidade oral. O tratamento cirúrgico só é necessário em casos específicos quando o tórus interfere nas funções do sistema estomatognático ou na instalação de prótese total no palato. O presente estudo teve como objetivo relatar um caso clínico de tratamento cirúrgico de extenso tórus palatino onde foi empregado um acesso cirúrgico modificado. Relato de caso: Esse trabalho descreve o caso de uma paciente com um tórus palatino de dimensões atípicas com queixas fonéticas e protéticas. Devido ao tamanho da exostose e para permitir uma abordagem mais simplificada, optou-se por um acesso cirúrgico modificado, que em conjunto com a confecção de placa em resina acrílica para instalação no pós-operatório, auxiliou na recuperação e conforto da paciente. Considerações Finais: A técnica cirúrgica utilizada preveniu possíveis desvantagens relacionadas à técnica tradicional, portanto, garantiu um pós-operatório confortável, podendo ser aplicada em tratamentos de tórus palatino quando bem indicada... (AU)

Introduction: Palatine torus is characterized by a non-pathological bone development that occurs along the midline of the hard palate. It`s etiology is related to genetic and environmental factors, being the most common exostoses in the oral cavity. Surgical treatment is only necessary in specific cases when the torus interferes in the functions of the stomatognathic system or in the installation of total prosthesis in the palate. The present study aimed to report a clinical case of surgical treatment of extensive palatine torus where a modified surgical approach was employed. Case report: This article describes the case of a patient with a palatine torus of atypical dimensions with phonetic and prosthetic complaints.Due to the size of the exostoses and to allow a more simplified approach, a modified surgical access was chosen, which together with the confection of acrylic resin plaque for postoperative installationaided in patient recovery and comfort. Final considerations: The surgical technique used prevented possible disadvantages related to the traditional technique, therefore, it guaranteed a comfortable postoperative period... (AU)

Exostose palatina aberrante / Exostosis palatina aberrante / Aberrant palatal exostosis

RESUMO Introdução: Exostose é um crescimento ósseo benigno que comumente acomete a mandíbula e a maxila, porém raramente apresenta grandes dimensões. Objetivo: Descrever um caso de exostose palatina de apresentação rara e discutir os principais aspectos clínicos envolvidos. Relato de caso: Paciente, gênero masculino, 66 anos, melanoderma, com história de aumento de volume no palato duro com tempo de evolução indeterminado, sem queixas álgicas, porém relatava transtornos de mastigação e fonação. O conjunto da lesão obliterava toda a profundidade do palato e ocupava grande volume na cavidade oral. A Tomografia Computadorizada de Feixe Cônico demonstrava áreas bem corticalizadas na superfície da lesão e áreas centrais menos hiperdensas, compatíveis com osso medular maduro. Após exames e pareceres pós-operatórios o paciente foi submetido a tratamento cirúrgico sob anestesia geral para remoção da massa óssea e osteoplastia subjacente, a fim de dar contornos normais ao palato, e o material colhido foi enviado para a biópsia que estabeleceu o diagnóstico de exostose. O paciente evoluiu sem complicações. Conclusão: Embora a exostose seja um crescimento ósseo benigno, ela causou problemas funcionais ao paciente, necessitando assim de um tratamento cirúrgico. Após três meses da remoção, os distúrbios foram revertidos à normalidade, e a sua reabilitação protética está em andamento(AU)

RESUMEN Introducción: La exostosis es un crecimiento óseo benigno que generalmente afecta la mandíbula y el maxilar, pero rara vez es grande. Objetivo: Describir un caso de exostosis palatina rara y discutir los principales aspectos clínicos involucrados. Presentación del caso: Paciente masculino de 66 años, melanoderma, con antecedentes de aumento de volumen del paladar duro con una evolución de tiempo indefinido, trastornos de masticación y fonación El conjunto de lesiones borró toda la profundidad del paladar y ocupó un gran volumen en la cavidad bucal. La tomografía computarizada de haz cónico mostró áreas corticalizadas en la superficie de la lesión y áreas centrales menos hiperdensas, compatibles con la médula ósea madura. Después de los exámenes y consejos preoperatorios, el paciente se sometió a un tratamiento quirúrgico con anestesia general para eliminar la masa ósea con osteoplastia subyacente a fin de obtener contornos del paladar normales, y el material recolectado fue enviado para realizar biopsia que estableció el diagnóstico de exostosis. El paciente progresó sin complicaciones. Conclusiones: Aunque la exostosis es un crecimiento óseo benigno, causó problemas funcionales al paciente, por lo que requirió tratamiento quirúrgico. Tres meses después de la extracción, los trastornos han vuelto a la normalidad y su rehabilitación protésica está en proceso(AU)

ABSTRACT Introduction: Exostosis is a benign bone growth that commonly affects the jaw and maxilla, but is rarely large. Objective: Describe a case of rare palatal exostosis and discuss the main clinical aspects involved. Case presentation: A case is presented of a male 66-year-old dark-skin patient with a history of hard palate enlargement of an indefinite time of evolution, and chewing and phonation disorders. The lesions had obliterated the entire palatal depth and occupied a large section of the oral cavity. Cone beam computed tomography revealed corticalized areas on the surface of the lesion and less hyperdense central areas compatible with mature bone marrow. After preoperative examination and advice, the patient underwent surgical treatment under general anesthesia to remove the bone mass and underlying osteoplasty to obtain normal palatal contours. The material collected was sent for biopsy testing, which established the diagnosis of exostosis. The patient recovered without any complications. Conclusions: Although exostosis is a benign bone growth, in this case it caused functional problems to the patient, thus requiring surgical treatment. Three months after removal, the disorders have been reverted to normal and prosthetic rehabilitation is underway(AU)

Pleomorphic adenoma of the hard palate with calcifications: an unusual presentation / Adenoma pleomórfico del paladar duro con calcificaciones: una presentación inusual

Pleomorphic Adenoma (PA) is the most common benign salivary gland tumor. The most common sites for minor salivary gland from which PA arises are the palate followed by the lips and buccal mucosa. Calcifications are a common finding in major salivary glands with chronic inflammatory disorders. Major salivary gland tumors rarely show calcifications and it is less common to find them in minor salivary gland tumors. We report a case of pleomorphic adenoma of the hard palate in a 67-year-old female patient with intra-tumoral, irregular and scattered calcifications visible on computed tomography (CT). The treatment was complete surgical excision of the lesion. The diagnosis was confirmed with the histopathological study.

El adenoma pleomórfico (AP) es el tumor benigno de las glándulas salivales más común. Los sitios de mayor frecuencia donde surge el AP en glándulas salivales menores es el paladar seguido de los labios y la mucosa bucal. Las calcificaciones son un hallazgo común en las glándulas salivales mayores con trastornos inflamatorios crónicos, pero en el caso de tumores rara vez muestran calcificaciones y es menos común encontrarlos en tumores de las glándulas salivales menores. Presentamos un caso de adenoma pleomórfico del paladar duro en una paciente de 67 años con calcificaciones intratumorales, irregulares y dispersas visibles en la tomografía computarizada. El tratamiento fue la extirpación quirúrgica completa de la lesión. El diagnóstico se confirmó con el estudio histopatológico

Computerized morphometry of the area of the hard palate and of palatal rugae: a cross-sectional study / Morfometría computarizada del área del paladar duro y de las arrugas palatinas: un estudio transversal

Abstract Background: The evaluation of palatal rugae in human identification is important because these structures can remain intact for up to seven days after death. Aim: To compare the area and density of the palatal rugae between ages groups and genders. Settings and Design: A cross-sectional study. Methods and Material: Dental plaster models obtained from patients at the Orthodontic Clinic of University of Uberaba were selected. Two hundred patients were divided into four groups: Group 1:10-15 years; Group 2:16-30 years; Group 3:31-50 years; and Group 4:51-70 years. The palatal rugae and hard palate of each plaster model were outlined and photographed. The evaluation of the area of the hard palate and palatal rugae was performed using the ImageJ software. Statistical analysis used: Kolmogorov-Smirnov, Kruskal-Wallis, Chi-square and Spearman correlation tests using GraphPad Prism 5 statistical software. Results and conclusión: The areas of the palatal rugae and of the hard palate were significantly smaller in the group 4. There was a significant negative correlation between age and palatal rugae area, and between age and hard palatal area. The present study was the first to demonstrate that patients between 51 and 70 years have a smaller palatal rugae area and a smaller hard palate area when compared to other groups. Thus, the evaluation of the hard palate area and of palatal rugae could be used as an adjunct with other methods to determine the age group of an individual; however studies using larger sample size are needed to validate this observation.

Abordagem minimamente invasiva para tratamento de adenoma pleomórfico em palato: caso clínico / Minimally invasive approach for pleomorfic adenoma treatment in palate: clinical case

Introdução: O adenoma pleomórfico (AP) ou tumor misto benigno é a neoplasia de glândula salivar mais comum. A glândula parótida geralmente é a mais acometida com 80% dos casos, e, quando surge em glândulas salivares menores, o palato é a região mais afetada. O objetivo deste trabalho é relatar um caso clínico de AP em palato duro, tratado de forma conservadora. Relato de caso: Paciente 35 anos, gênero masculino, apresentando aumento de volume em palato, aos 6 meses de evolução, foi submetido à realização de procedimento cirúrgico, realizado sob anestesia local, para enucleação da lesão, seguido por curetagem de periósteo e com preservação de tecido mucoso sobrejacente. Considerações Finais: No momento, o paciente encontra-se com 1 ano de acompanhamento e não apresenta sinais de recidiva... (AU)

Introduction: Pleomorphic adenoma (PA) or benign mixed tumor is a more common salivary gland neoplasia. The parotid gland is usually the most affected with 80% of the cases and when they appear in smaller salivary glands, the palate is a region more affected. The objective of this study is to report a case of PA in the hard palate, treated conservatively. Case report: Patient 35 years old, male, presenting a palate volume increase with 6 months of evolution and submitted to surgical surgery performed under local anesthesia for enucleation of the process followed by periosteum cures and preservation of overlying mucosal tissue. Final considerations: At the moment, the patient is 1 year of follow-up and shows no signs of relapse... (AU)

Injerto en bloque para la regeneración horizontal y vertical por palatino en brecha unitaria. Implicancia clínica del conducto nasopalatino / Block graft for horizontal and vertical regeneration by palatal in unit gap: clinical implications of nasopalatine canal

Objetivo: Describir un abordaje quirúrgico con injerto en bloque en relación con el conducto nasopalatino y evaluar su desempeño clínico, la percepción sensorial del paciente y el resultado estético en el tratamiento implanto-protésico. Materiales y métodos: Se realizó un estudio clínico en una serie de 10 pacientes con defecto óseo que incluía el conducto nasopalatino con ensanchamiento desfavorable del foramen incisivo. Se colocaron 10 implantes: 6 en incisivo central derecho y 4 en incisivo central izquierdo. La rehabilitación implanto-protésica se llevó a cabo en tres etapas: 1) Diagnóstica: Se evaluaron parámetros clínicoestéticos y se realizó tomografía computarizada de haz cónico; 2) Quirúrgica: Se colocó injerto en bloque por palatino e incisal con regeneración ósea guiada simultánea, y entre seis y diez meses después se colocaron implantes de 3,8 mm de diámetro y una longitud de 10,5 a 15 mm; 3) Protésica: Se atornilló la corona con un torque de 32 N. Se realizó el seguimiento de los pacientes durante 2 a 9 años, en el que se evaluó espesor de la cresta ósea, prueba neurosensorial, percepción del paciente e índices estéticos rosa y blanco. Resultados: Previamente a la cirugía, la media y la desviación estándar del ancho vestibulopalatino de la cresta anterior, a nivel del foramen incisivo, en las alturas 4 mm, 8 mm y 14 mm apicales a la cresta ósea marginal eran de 3,5±2 mm, 5,4±1,5 mm y 6,1±1,9 mm, respectivamente. Las medias totales del espesor postratamiento de la cresta vestibulopalatina en las mismas alturas fueron de 10,09±2,01 mm, 10,5±1 mm y 13,4±3 mm. La evaluación de los resultados de los índices estéticos rosa y blanco fue satisfactoria. Ningún paciente informó alteración neurosensorial. Conclusión: Las variaciones anatómicas del conducto nasopalatino pudieron ser compensadas con un aumento óseo. El injerto en bloque y particulado optimizó la posición tridimensional del implante mejorando el contorno facial del paciente. El control realizado entre 2 y 9 años mostró estabilidad de los tejidos y mantención de la estética lograda.

Aim: To describe a surgical approach with a bloc graft in relation to the nasopalatine duct, to evaluate its clinical performance, the sensory perception, as well as the aesthetic result of the implant prosthetic treatment. Materials and methods: A clinical study was conducted on a series of 10 consecutive patients with bone defects involving the nasopalatine duct with unfavourable widening of the incisive foramen, in which 10 implants were placed, 6 in the right and 4 in the left central incisor. The implant-prosthetic rehabilitation was performed in three stages: 1) Diagnosis: clinical-aesthetic parameters were evaluated and Cone Beam computed tomography scans were analysed; 2) Surgical: a block graft was placed palatal and incisal with simultaneous guided bone regeneration and between 6 and 10 month later implants were placed; 3) Prosthetic: crowns were screwed with a torque of 32 N. Patient follow-up was between 2 to 9 years. Outcomes assessed were: thickness of the bone crest, sensorineural test, pink and white aesthetics scores