Retinoic Acid Upregulates METTL14 Expression and the m6A Modification Level to Inhibit the Proliferation of Embryonic Palate Mesenchymal Cells in Cleft Palate Mice.

Cleft palate only (CPO) is one of the most common craniofacial birth defects. Environmental factors can induce cleft palate by affecting epigenetic modifications such as DNA methylation, histone acetylation, and non-coding RNA. However, there are few reports focusing on the RNA modifications. In this study, all-trans retinoic acid (atRA) was used to simulate environmental factors to induce a C57BL/6J fetal mouse cleft palate model. Techniques such as dot blotting and immunofluorescence were used to find the changes in m6A modification when cleft palate occurs. RNA-seq and KEGG analysis were used to screen for significantly differentially expressed pathways downstream. Primary mouse embryonic palate mesenchymal (MEPM) cells were successfully isolated and used for in vitro experimental verification. We found that an increased m6A methylation level was correlated with suppressed cell proliferation in the palatine process mesenchyme of cleft palate mice. This change is due to the abnormally high expression of m6A methyltransferase METTL14. When using siRNAs and the m6A methyltransferase complex inhibitor SAH to interfere with the expression or function of METTL14, the teratogenic effect of atRA on primary cells was partially alleviated. In conclusion, METTL14 regulates palatal mesenchymal cell proliferation and cycle-related protein expression relies on m6A methylation modification, affecting the occurrence of cleft palate.

Does krill oil enhancing the new bone formation in orthopedically expanded median palatal suture in rat model? A micro-CT and immunohistochemical analysis.

BACKGROUND: The purpose of this study was to assess the effects of systemically given krill oil (KO) on the development of new bone formation in the sutura palatina media following rapid maxillary expansion (RME). METHODS: 28 4-5 week-old male Wistar albino rats were randomly divided into 4 groups: Control (C), Only Expansion (OE) (no supplement but undergoing expansion and retention), KE (supplemented during both the expansion and retention phases), Krill Oil Nursery Group (KN) (supplemented during the 40-day nursery phase as well as during the expansion and retention phases). A 5-day RME was followed by a 12-day retention period. All rats were euthanized simultaneously. Micro-computerized tomography (Micro-CT), hemotoxylen-eosin (H&E) staining, and immunohistochemical analysis were conducted. Kruskal-Wallis and Dunn tests with Bonferonni corrrection were applied (p < 0.05). RESULTS: Expansion and KO supplementation did not cause a statistically significant change in bone mineral density (BMD), bone volume fraction (BV/TV), spesific bone surface (BS/BV) and trabecular thickness (Tb.Th). While the expansion prosedure increased the trabecular seperation (Tb.Sp), KO supplemantation mitigated this effect. The KE group exhibited a statistically significantly increase in trabecular number (Tb.N) compared to the OE group. Although receptor activator of nuclear factor-kappa-Β ligand (RANKL)/osteoprotegerin (OPG) ratios did not show significant differences between groups, the KE and OE groups demonstrated the lowest and highest value, respectively. KE showed a reduced amount of tartrate-resistant acid phosphatase (TRAP) compared to the OE. CONCLUSION: KO positively affected the architecture of the new bone formed in the mid-palatal suture. In this rat model of RME, results support the idea that administering of KO during the expansion period or beginning before the RME procedure may reduce relapse and enhance bone formation within the mid-palatal suture.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review.

PURPOSE: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. METHODS: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. RESULTS: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. CONCLUSIONS: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Florid follicular lymphoid hyperplasia of the palate: review of the literature and report of an illustrative case.

OBJECTIVE: The aim of this report was to review oral follicular lymphoid hyperplasia, with emphasis on palatal lesions. METHOD AND MATERIALS: A comprehensive search was performed on PubMed for case reports and case series of palatal follicular lymphoid hyperplasia published in the English language literature. Relevant data from collated articles was sought, including patient demographics, clinical manifestations, imaging modalities and findings, comorbidities, etiopathogenesis, lesional management, and lesional outcome. A new palatal case has also been provided to illustrate several features of this lesion. RESULTS: In total, 32 cases were assembled to establish clinicopathologic correlations, representing the largest aggregation of published cases. Most of the affected patients were at least 60 years old and with a decisive female predilection. The majority of lesions were ≤ 3 cm, appearing as normal color, purple-red or red, and varied from soft to firm. Notably, 32% of palatal follicular lymphoid hyperplasias were associated with denture wear, and lesional recurrence was recorded in 16% of cases. To date, none of the reported cases of palatal follicular lymphoid hyperplasia has undergone malignant transformation. CONCLUSIONS: Palatal follicular lymphoid hyperplasias often arise as a reactive process. Critical histopathologic and histochemical assessments are necessary to establish benignity. Postoperatively, clinicians should follow patients for at least 5 years for recurrence and remain vigilant for neoplastic change as several published accounts of non-oral follicular lymphoid hyperplasias have undergone malignant transformation, usually to lymphoma.

Three-dimensional analysis of palatal morphology and PAS in patients with cleft lip and palate prior to orthodontic treatment.

BACKGROUND: Since many different conclusions of craniofacial anomalies and their relation to the posterior airway space coexist, this comparative clinical study investigated the palatal morphology concerning volumetric size, posterior airway space dimension and the adenoids of patients with and without a cleft before orthodontic treatment. METHODS: Three-dimensional intraoral scans and cephalometric radiographs of n = 38 patients were used for data acquisition. The patients were divided into three groups: unilateral cleft lip and palate (n = 15, 4 female, 11 male; mean age 8.57 ± 1.79 years), bilateral cleft lip and palate (n = 8, 0 female, 8 male; mean age 8.46 ± 1.37 years) and non-cleft control (n = 15, 7 female, 8 male; mean age 9.03 ± 1.02 years). The evaluation included established procedures for measurements of the palatal morphology and posterior airway space. Statistics included Shapiro-Wilk-Test and simple ANOVA (Bonferroni) for the three-dimensional intraoral scans and cephalometric radiographs. The level of significance was set at p < 0.05. RESULTS: The palatal volume and cephalometric analysis showed differences between the three groups. The palatal volume, the superior posterior face height and the depth of the bony nasopharynx of patients with cleft lip and palate were significantly smaller than for non-cleft control patients. The superior posterior face height of bilateral cleft lip and palate patients was significantly smaller than in unilateral cleft lip and palate patients (BCLP: 35.50 ± 2.08 mm; UCLP: 36.04 ± 2.95 mm; p < 0.001). The percentage of the adenoids in relation to the entire nasopharynx and the angle NL/SN were significantly bigger in patients with cleft lip and palate than in the non-cleft control. In particular, the palatal volume was 32.43% smaller in patients with unilateral cleft lip and palate and 48.69% smaller in patients with bilateral cleft lip and palate compared to the non-cleft control. CONCLUSIONS: Skeletal anomalies relate to the dimension of the posterior airway space. There were differences among the subjects with cleft lip and palate and these without a cleft. This study showed that the morphology of the palate and especially transverse deficiency of the maxilla resulting in smaller palatal volume relates to the posterior airway space. Even the adenoids seem to be affected, especially for cleft lip and palate patients.

Oral manifestations of systemic fungal infections: 25-year experience in an endemic region

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.

Uso de laser de alta potência para remoção de granuloma piogênico em palato: relato de um caso / Use of high power laser to remove piogenic granuloma in the palate: a case report

A laserterapia na área odontológica oferece ao paciente e ao profissional uma alternativa terapêutica em relação a métodos convencionais. O uso do laser de alta potência em procedimentos cirúrgicos apresenta inúmeras vantagens, uma vez que reduz o sangramento durante a diérese, proporciona uma boa visão do campo operatório e torna mais curto e conveniente o tempo do procedimento. O objetivo deste trabalho é relatar um caso de remoção cirúrgica de granuloma piogênico em palato mole com Laser de diodo de alta potência. A paciente do sexo feminino com 75 anos foi encaminhada à Clínica Escola de Odontologia com lesão em palato, com hipótese diagnóstica de granuloma piogênico. O tratamento de escolha foi a exérese da lesão com o Laser de diodo Thera Lase surgery (DMC equipamentos, São Carlos/SP, Brasil) 808nm, meio ativo de Gallium-Indium-Arsenide (InGaAs), 3500mW, 4J e frequência contínua, a amostra foi encaminhada para o Laboratório de Histopatologia oral para análise histopatológica, sendo confirmado como granuloma piogênico fibrosado. O Laser cirúrgico utilizado foi eficaz na excisão da lesão, permitindo excelente hemostasia, acesso cirúrgico à lesão e fácil manuseio, não ocorrendo intercorrências trans- e/ou pós-operatórias. Após 3 anos de acompanhamento periódico, não houve recidiva da lesão... (AU)

Laser therapy in the dental field offers the patient and the professional an alternative to conventional methods. The use of high-powered laser in surgical procedures has numerous advantages, since it reduces bleeding during the incision, provides a good view of the operative field, the procedure time becomes shorter and more convenient. The objective of this work is to report a case of surgical removal of pyogenic granuloma in the soft palate with a high-power diode laser. The 75 year old female patient was referred to the Dental School Clinic with a palate lesion, with a diagnostic hypothesis of pyogenic granuloma. The treatment of choice was the excision of the lesion with the Thera Lase surgery diode laser (DMC equipment, São Carlos / SP, Brazil) 808 nm, active medium Gallium-Indium-Arsenide (InGaAs), 3500mW, 4J and continuous frequency, the sample was sent to the Oral Histopathology Laboratory for histopathological analysis, being confirmed as fibrous pyogenic granuloma. The surgical laser used was effective in excising the lesion, hemostasis was satisfactory, handling was practical, easy access to the area to be excised, there was no intraoperative complication and no postoperative complications were reported. The patient after about 3 years of periodic follow-up is healthy and has no recurrence of the lesion... (AU)

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.

Variability of exostoses on human jaws during the past six millennia in Northern China / Variabilidad de las exostosis en las mandíbulas humanas durante los últimos seis milenios en el norte de China

SUMMARY: The aim of this study was to survey oral exostoses in human populations that belonged to the same region encompassing five periods over 6000 years, to determine the prevalence and its changing trend over time. A total of 306 human jaws belonging to the modern Xi'an region and four archeological sites, Banpo (6700-5600 years BP), Shaolingyuan (3000 years BP), Shanren (2200 years BP) and Chang'an (1000-1300 years BP), were investigated. The degree of buccal exostosis (BE), torus mandibularis (TM) and torus palatinus (TP) and the TP shape were recorded. The prevalence of BE, TM, and TP in the five groups was 20.8 %-62.5 %, 17.5 %-71.5 %, and 31.7 %-74.2 %, respectively. The differences in the three types of exostoses among the five groups were all statistically significant, but only TM and TP showed a decreasing trend over time. A high and quite diverse prevalence of oral exostoses was found in the five groups of samples. Decreasing trends in relation to time for TM and TP were detected.

RESUMEN: El objetivo de este estudio fue sondear las exostosis orales en poblaciones humanas que pertenecían a la misma región abarcando cinco períodos durante 6000 años, para determinar la prevalencia y su tendencia cambiante a lo largo del tiempo. Un total de 306 mandíbulas humanas pertenecientes a la moderna región de Xi'an y cuatro sitios arqueológicos, Banpo (6700-5600 años AP), Shaolingyuan (3000 años AP), Shanren (2200 años AP) y Chang'an (1000-1300 años AP) BP), fueron investigados. Se registró el grado de exostosis bucal (EO), torus mandibular (TM) y torus palatino (TP) y la forma de TP. La prevalencia de EO, TM y TP en los cinco grupos fue 20,8 % -62,5 %, 17,5 % -71,5 % y 31,7 % -74,2 %, respectivamente. Las diferencias en los tres tipos de exostosis entre los cinco grupos fueron todas estadísticamente significativas, pero solo TM y TP mostraron una tendencia decreciente con el tiempo. Se encontró una prevalencia alta y bastante diversa de exostosis oral en los cinco grupos de muestras. Se detectaron tendencias decrecientes en relación al tiempo para TM y TP.

Geographic stomatitis with palate involvement

Abstract: Benign migratory glossitis or geographic tongue is a benign condition that usually manifests as asymptomatic erythematous and migratory circinate patches, involving the lateral and dorsal aspects of the tongue. Extra-lingual lesions uncommonly occur and are mainly located on labial and buccal mucosae, lips and floor of the mouth. The present report describes one patient with a geographic lesion on the hard palate associated with lingual lesions and another patient who had multiple geographic lesions both in the hard and soft palate without lingual lesions. We found 64 cases in the English literature of ectopic locations with 22 palate involvement. No case of simultaneous involvement of the hard and the soft palate was found.

State-dependent changes in the upper airway assessed by multidetector CT in healthy individuals and during obstructive events in patients with sleep apnea / Alterações nas vias aéreas superiores avaliadas por TC multidetectores durante a vigília e o sono em indivíduos saudáveis e em pacientes com apneia do sono durante eventos obstrutivos

ABSTRACT Objective: To determine whether airway narrowing during obstructive events occurs predominantly at the retropalatal level and results from dynamic changes in the lateral pharyngeal walls and in tongue position. Methods: We evaluated 11 patients with severe obstructive sleep apnea (OSA) and 7 healthy controls without OSA during wakefulness and during natural sleep (documented by full polysomnography). Using fast multidetector CT, we obtained images of the upper airway in the waking and sleep states. Results: Upper airway narrowing during sleep was significantly greater at the retropalatal level than at the retroglossal level in the OSA group (p < 0.001) and in the control group (p < 0.05). The retropalatal airway volume was smaller in the OSA group than in the control group during wakefulness (p < 0.05) and decreased significantly from wakefulness to sleep only among the OSA group subjects. Retropalatal pharyngeal narrowing was attributed to reductions in the anteroposterior diameter (p = 0.001) and lateral diameter (p = 0.006), which correlated with an increase in lateral pharyngeal wall volume (p = 0.001) and posterior displacement of the tongue (p = 0.001), respectively. Retroglossal pharyngeal narrowing during sleep did not occur in the OSA group subjects. Conclusions: In patients with OSA, upper airway narrowing during sleep occurs predominantly at the retropalatal level, affecting the anteroposterior and lateral dimensions, being associated with lateral pharyngeal wall enlargement and posterior tongue displacement.

Resumo Objetivo: Determinar se o estreitamento das vias aéreas durante eventos obstrutivos ocorre predominantemente na região retropalatal e resulta de alterações dinâmicas nas paredes laterais da faringe e na posição da língua. Métodos: Avaliamos 11 pacientes com apneia obstrutiva do sono (AOS) grave (grupo AOS) e 7 indivíduos saudáveis sem AOS (grupo controle) durante a vigília e o sono natural (documentado por meio de polissonografia completa). Por meio de TC multidetectores rápida, obtivemos imagens das vias aéreas superiores no estado de vigília e de sono. Resultados: O estreitamento das vias aéreas superiores durante o sono foi significativamente maior na região retropalatal do que na região retrolingual no grupo AOS (p < 0,001) e no grupo controle (p < 0,05). O volume da via aérea retropalatal foi menor no grupo AOS do que no grupo controle durante a vigília (p < 0,05) e diminuiu significativamente da vigília ao sono apenas no grupo AOS. O estreitamento retropalatal da faringe foi atribuído à redução do diâmetro anteroposterior (p = 0,001) e lateral (p = 0,006), que se correlacionou com o aumento do volume das paredes laterais da faringe (p = 0,001) e o deslocamento posterior da língua (p = 0,001). Não ocorreu estreitamento retrolingual da faringe durante o sono no grupo AOS. Conclusões: Em pacientes com AOS, o estreitamento das vias aéreas superiores durante o sono ocorre predominantemente na região retropalatal e afeta as dimensões anteroposterior e lateral, além de estar relacionado com aumento das paredes laterais da faringe e deslocamento posterior da língua.

Maxillary Osteomyelitis by Actinomyces in a Child / Osteomielitis Maxilar por Actinomyces en un Niño

ABSTRACT: Actinomycosis is a bacterial infection caused by Actinomyces species, which usually affect the soft tissues of the cervicofacial region of adult males. Clinically, it's characterized by a slow-growing indurated mass, especially in the submandibular area. However, in a few cases, the jaws bones can be affected developing osteomyelitis characteristics. The aim of this paper is to report a rare clinical case of Actinomycotic Osteomyelitis affecting the maxilla of a child, involving the maxillary sinus, orbital and zygomatic areas that was treated by the association of antibiotic therapy and surgical debridement. The patient's 2 years follow-up was uneventful and no signs of the lesion recurrence.

RESUMEN: La actinomicosis es una infección bacteriana causada por la especie Actinomyces, que generalmente afecta los tejidos blandos de la región cervicofacial de los hombres adultos. Clínicamente, se caracteriza por una masa endurecida de crecimiento lento, especialmente en la zona submandibular. Sin embargo, en algunos casos, los huesos de las mandíbulas pueden ser afectados desarrollando características de osteomielitis. El objetivo de este trabajo es reportar un caso clínico poco frecuente de osteomielitis actinomicótica que afecta el maxilar de un niño, envolviendo el área del seno maxilar, y zonas orbitales y cigomáticas que fueron tratadas con la asociación de terapia con antibióticos y desbridamiento quirúrgico. El seguimiento del paciente por 2 años ocurrió sin incidentes y sin signos de recidiva de las lesiones.

Maxillary sinus floor pneumatization and alveolar ridge resorption after tooth loss: a cross-sectional study

Abstract This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p < 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First molars were mostly affected by LSP at TS (36 out of 43). Individuals with LSP at TS presented lower HR than the ones without LSP (p < 0.05). 54% of the cases presenting LSP obtained HR < 5 mm, which indicates sinus lift surgery. The present study showed that tooth loss in posterior maxilla favors sinus pneumatization and the identification of LSP at molar roots seems to indicate a greater necessity for sinus lift surgeries.

Odontoma Compuesto: Diagnóstico y Tratamiente Reporte de Casos & Revisión de la Literatura / Compound Odontoma: Diagnosis and Treatment Therapeutic Measures. Case Reports & Literature Review

RESUMEN: Los odontomas son los tumores odontogénicos benignos más prevalentes. Estos están conformados por tejido dentario, epitelio odontogénico y tejido mesenquimático. Se dividen en dos subtipos: odontomas compuestos, que presentan tejidos dentarios normales, pero con una alteración en su conformación y tamaño, y odontomas complejos, que presentan tejidos dentarios bien formados, pero rodeados de tejido desorganizado. Se presentan tres casos de pacientes sexo femenino, quienes acuden para evaluación y tratamiento debido al hallazgo radiográfico de odontoma compuesto. En el caso nº 1 se realizó la desinclusión del diente impactado, la exodoncia del diente remanente, la exéresis del odontoma compuesto, la instalación de un implante dental en el alveolo de la zona intervenida y, finalmente, el posicionamiento de injerto óseo. En el caso nº 2 se realizó la exodoncia del diente temporal remanente y la exéreis del odontoma compuesto. Ambos casos evolucionaron de manera favorable sin complicaciones post operatorias. En el caso nº 3 se realizó la fenestración del diente 18 y la exéreis del odontoma compuesto que retenía su erupción. Todos los casos evolucionaron de manera favorable sin complicaciones post operatorias. Dada la prevalencia de esta patología, es necesario un adecuado conocimiento sobre ella y sus características, para realizar un adecuado diagnóstico y tratamiento. Existen distintas medidas terapéuticas respecto a la rehabilitación de una zona edéntula como resultado de la exéresis de estos tumores. Esto depende principalmente de la edad del paciente. Al ser requeridas medidas rehabilitadoras, un punto importante a considerar es la posibilidad de realizar todos los procedimientos quirúrgicos en un solo tiempo operatorio.

ABSTRACT: Odontomas are the most common benign odontogenic tumors and are composed of dental tissue, odontogenic epithelium and mesenchymal tissue. They are divided into two subtypes: Compound odontomas, which present normal tooth tissue, but an alteration in their conformation and size, and complex odontomas, which present well-formed tooth tissue, but are surrounded by disorganized tissue. A bibliographic review was performed by one operator in Pubmed and Epistemonikos. After filtering by title and abstract, only one systematic review was selected. We present two clinical cases of compound odontoma in female patients at the Military Hospital in Santiago. Patients were referred for evaluation and treatment due to the radiographic finding of compound odontoma. In case # 1, the impacted tooth was disincluded, the remaining temporal tooth was extracted, and excision of the compound odontoma carried out; subsequently a bone graft implant was placed in the remaining socket. In case # 2, the remaining temporal tooth was extracted and compound odontoma excised. After that, natural eruption of the corresponding permanent tooth is expected. In case # 3, tooth 1.8 fenestration and excision of compound odontoma was performed. In this case also, natural eruption of the corresponding permanent tooth is expected. Given the prevalence of this pathology, adequate knowledge of compound odontomas and their characteristics is necessary for proper diagnosis and treatment. There are different therapeutic measures for the rehabilitation of an edentulous area following excision of compound odontoma. This depends mainly on the age of the patient. When rehabilitation measures are required, an important aspect to consider for the patient, is the possibility of a single surgical event, as was done in case # 1.

Minor intraoral salivary gland tumors: a clinical-pathological study / Neoplasias intraorais de glândula salivar menor: estudo clínico-patológico

ABSTRACT Objective To evaluate the clinical-pathological profile of patients with minor salivary gland neoplasms. Methods A retrospective study of specific cases diagnosed as benign and malignant tumors of the minor salivary glands was performed. The data were collected from medical records of patients seen at a hospital over a period of 15 years. The sample was made up of 37 cases. For the pathological study, slides containing 5μm thick sections stained with hematoxylin and eosin were used. The data were tabulated using descriptive statistics. Results Malignant neoplasms represented 70.3% of cases. The mucoepidermoid carcinoma was the most common neoplasm (45.9%), followed by pleomorphic adenoma (24.4%). Most patients were female (70.3%), aged between 71 and 80 years. The palate (67.6%) and the retromolar region (10.8%) were the most affected sites. Conclusion Mucoepidermoid carcinoma was the most common tumor in minor salivary glands. These tumors are more common in females aged over 40 years. The palate was the most common affected site.

RESUMO Objetivo Avaliar o perfil clínico-patológico de pacientes com neoplasias de glândula salivar menor. Métodos Foi realizado um estudo retrospectivo de casos específicos diagnosticados como neoplasias benignas ou malignas de glândula salivar menor. Os dados foram coletados dos prontuários dos pacientes atendidos em um hospital no período de 15 anos. A amostra final foi de 37 casos. Para o estudo histopatológico, foram usadas lâminas contendo secções com 5μm de espessura, coradas pela técnica de hematoxilina e eosina. Os dados foram tabulados de forma descritiva. Resultados As neoplasias malignas representaram 70,3% dos casos. O tipo histológico mais prevalente foi o carcinoma mucoepidermoide (45,9%), seguido do adenoma pleomórfico (24,4%). A maioria dos pacientes era do sexo feminino (70,3%), com idade entre 71 e 80 anos. O palato (67,6%) e a região retromolar (10,8%) foram os sítios mais acometidos. Conclusão O carcinoma mucoepidermoide foi o tumor mais comum das glândulas salivares menores. Estes tumores foram mais comuns em mulheres com mais de 40 anos. O palato foi o sítio mais acometido.

Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

INTRODUCTION: Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. METHODS: The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). RESULTS: Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. CONCLUSIONS: The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height. .

INTRODUÇÃO: devido ao número reduzido de estudos que distinguem entre as mudanças dentoalveolares e ósseas produzidas pelo aparelho de Thurow, esse estudo clínico, conduzido pelo departamento de Ortodontia da Faculdade de Odontologia de Araraquara, foi proposto para avaliar as mudanças dentárias e esqueléticas induzidas pelo aparelho de Thurow modificado. MÉTODOS: a amostra incluiu um grupo experimental de 13 indivíduos, entre 7 e 10 anos de idade, com má oclusão Classe II e mordida aberta anterior, e um grupo controle de 22 indivíduos, com idades, plano mandibular e má oclusão similares. Com base em 14 pontos cefalométricos, 8 ângulos (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) e 3 medidas lineares (N-Me, ANS-Me, S-Go), foram avaliados movimentos maxilares e mandibulares horizontais e verticais dentários e esqueléticos (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6). RESULTADOS: o tratamento produziu diminuição significativamente maior no ângulo entre o plano palatino e o plano mandibular do grupo controle, devido ao aumento do ângulo do plano palatino. Os ângulos A-N-B, S-N-A e S-N-ANS diminuíram significativamente mais no grupo tratado. A PNS sofreu remodelação superior. A altura facial inferior (ANS-Me) diminuiu no grupo tratado, ao passo que aumentou no grupo controle. CONCLUSÕES: o aparelho controlou deslocamento vertical e horizontal da maxila, rotacionou a maxila para melhorar a mordida aberta e diminuiu a altura facial inferior. .

Uso do retalho miomucoso do músculo bucinador bilateral para o tratamento de insuficiência velofaríngea: avaliação preliminar / Bilateral buccinator myomucosal flap for the treatment of velopharyngealinsufficiency: preliminary results

Velopharyngeal insufficiency in patients with cleft lip and palate is challenging for plastic surgeons. One of the treatment options is palatoplasty using buccinator muscle myomucosal flaps to extend the nasal and oral mucosa. This prospective study presents the preliminary results of the use of buccinator muscle myomucosal flaps for the treatment of velopharyngeal insufficiency in patients with cleft lip and palate. Methods: This study was performed between January 2010 and July 2012 at the Craniofacial Institute of the Hospital of SOBRAPAR. All patients with cleft lip and palate who had undergone nasofibroscopy and had severe velopharyngeal insufficiency with scar tissue accumulation in the oral cavity as observed by oroscopy, previous palatoplasty with total dissection of the soft palate, or were referred by other services were submitted to a secondary or in some cases, tertiary palatoplasty using a bilateral buccinator myomucosal flap to extend the soft palate. Results: Among 20 patients undergoing treatment, 4 (20%) were excluded from the analysis, 1 went from a very large to a large circular gap (5%), 6 went from a large circular gap to no gap (5%), 2 went from a medium to a small coronal gap (10%), and 3 exhibited no postoperative improvement (15%). Conclusions: Although longer postoperative follow-up is required, the results indicate THAT buccinator muscle flaps are reliable, reproducible, and lead to good final results.

A insuficiência velofaríngea em pacientes com fissura labiopalatal é um desafio para o cirurgião plástico e pode ser resolvida, entre outras maneiras, pela palatoplastia, com a utilização de retalhos miomucosos do músculo bucinador para alongar as mucosas nasal e oral. Este estudo prospectivo teve por objetivo fazer a avaliação preliminar do uso de retalho miomucoso do músculo bucinador bilateral para o tratamento da insuficiência velofaríngea em pacientes com fissura labiopalatal. Método: Entre janeiro de 2010 e julho de 2012, todos os pacientes do Hospital SOBRAPAR - Crânio e Face com fissura labiopalatal submetidos a nasofibroscopia e que apresentavam insuficiência velofaríngea grave, grande quantidade de tecido cicatricial na oroscopia, que já haviam sido submetidos a repalatoplastias com dissecção radical da musculatura do véu e/ou encaminhados de outros serviços foram submetidos a palatoplastia secundária, por vezes terciária, com retalho miomucoso bucinador bilateral para alongamento do véu palatino. Resultados: Dos 20 pacientes submetidos à técnica proposta, 4 pacientes foram excluídos do estudo (20%), 1 paciente passou de um gap circular muito grande para grande (5%) 6 passaram de circular grande para médio (30%) 2 de circular grande para pequeno (10%), 1 de circular grande para puntiforme (5%) 1 de circular grande para ausente (5%), 2 de coronal médio para coronal pequeno 10%) e 3 mantiveram o gap circular grande no pós-operatório (15%). Conclusões: Embora o presente estudo necessite de maior tempo de seguimento pós-operatório o retalho d músculo bucinador são confiáveis e de fácil reprodução, obtendo-se bons resultados.

Morphological characterization of the nasopalatine region in human fetuses and its association to pathologies

The nasopalatine region is composed of structures such as the vomeronasal organ and nasopalatine duct. The nasopalatine duct may provide the communication of the mouth to the nasal cavity in human fetuses and can be obliterated in an adult human. Knowledge on the development of the nasopalatine region and nasopalatine duct in humans is necessary for understanding the morphology and etiopathogenesis of lesions that occur in this region. Objective The aim of the present study was to describe the morphological aspects of the nasopalatine region in human fetuses and correlate these aspects with the development of pathologies in this region. Material and Methods Five human fetuses with no facial or palatine abnormalities were used for the acquisition of specimens from the nasopalatine region. After demineralization, the specimens were histologically processed. Histological cuts were stained with methylene blue to orient the cutting plane and hematoxylin-eosin for the descriptive histological analysis. Results The age of the fetuses was 8.00, 8.25, 9.00 and 9.25 weeks, and it was not possible to determine the age in the last one. The incisive canal was observed in all specimens as an opening delimited laterally by the periosteum and connecting oral and nasal cavity. The nasopalatine duct is an epithelial structure with the greatest morphological variation, with either unilateral or bilateral occurrence and total patent, partial patent and islet forms. The vomeronasal organ is a bilateral epithelized structure located alongside the nasal septum above the incisive canal in all the fetuses. Conclusions The incisive canal, nasopalatine duct and vomeronasal organ are distinct anatomic structures. The development of nasopalatine duct cysts may occur in all forms of the nasopalatine duct. .

Correlation analysis of alveolar bone loss in buccal/palatal and proximal surfaces in rats

The aim was to correlate alveolar bone loss in the buccal/palatal and the mesial/distal surfaces of upper molars in rats. Thirty-three, 60-day-old, male Wistar rats were divided in two groups, one treated with alcohol and the other not treated with alcohol. All rats received silk ligatures on the right upper second molars for 4 weeks. The rats were then euthanized and their maxillae were split and defleshed with sodium hypochlorite (9%). The cemento-enamel junction (CEJ) was stained with 1% methylene blue and the alveolar bone loss in the buccal/palatal surfaces was measured linearly in 5 points on standardized digital photographs. Measurement of the proximal sites was performed by sectioning the hemimaxillae, restaining the CEJ and measuring the alveolar bone loss linearly in 3 points. A calibrated and blinded examiner performed all the measurements. Intraclass Correlation Coefficient revealed values of 0.96 and 0.89 for buccal/lingual and proximal surfaces, respectively. The Pearson Correlation Coefficient (r) between measurements in buccal/palatal and proximal surfaces was 0.35 and 0.05 for the group treated with alcohol, with and without ligatures, respectively. The best correlations between buccal/palatal and proximal surfaces were observed in animals not treated with alcohol, in sites both with and without ligatures (r = 0.59 and 0.65, respectively). A positive correlation was found between alveolar bone loss in buccal/palatal and proximal surfaces. The correlation is stronger in animals that were not treated with alcohol, in sites without ligatures. Areas with and without ligature-induced periodontal destruction allow detection of alveolar bone loss in buccal/palatal and proximal surfaces.