RESUMEN
Although relatively rare, minor salivary gland tumors are more likely to be malignant in pediatric patients than in adults. Mucoepidermoid carcinoma (MEC) represents the most common malignant tumor of the salivary glands. It is critical to differentiate such tumors from common benign salivary gland lesions. The purposes of this report are to present the case of a 15-year-old female with MEC of the palate, and to discuss the importance of a thorough intraoral examination on all patients regardless of age, as well as the need for timely referral for appropriate diagnosis and treatment.
Asunto(s)
Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/cirugía , Neoplasias Palatinas/diagnóstico , Neoplasias Palatinas/cirugía , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/cirugía , Adolescente , Biopsia , Carcinoma Mucoepidermoide/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias Palatinas/patología , Radiografía Panorámica , Neoplasias de las Glándulas Salivales/patología , Tomografía Computarizada por Rayos XRESUMEN
IMAGe syndrome (OMIM 300290) is a rare multisystem disorder that has a broad phenotypic presentation. Though variable, this disorder mainly consists of Intrauterine growth retardation, Metaphyseal dysplasia, Adrenal hypoplasia congenita, and Genital abnormalities. Patients with IMAGe syndrome present as an uncommon yet important challenge for dentists and anesthesiologists due to their wide range of dysmorphic facial features, adrenal insufficiency, electrolyte imbalances, and need for steroid replacement. The purpose of this case report is to describe the successful anesthetic management of a pediatric patient diagnosed with IMAGe syndrome who presented for full mouth dental rehabilitation.
Asunto(s)
Insuficiencia Suprarrenal/complicaciones , Anestesia Dental , Anestesia General , Atención Dental para Enfermos Crónicos , Rehabilitación Bucal , Osteocondrodisplasias/complicaciones , Anomalías Urogenitales/complicaciones , Anestésicos por Inhalación/administración & dosificación , Preescolar , Caries Dental/terapia , Profilaxis Dental , Restauración Dental Permanente , Femenino , Retardo del Crecimiento Fetal , Gingivitis/terapia , Humanos , Intubación Intratraqueal/métodos , Absceso Periodontal/terapia , Extracción Dental , Diente Primario/patologíaRESUMEN
PURPOSE: The purposes of this study were to: (1) investigate adhesion through shear bond strength (SBS) testing of a resin composite bonded with a self-etching bonding system (SEB) to amelogenesis imperfecta (AI)-affected deproteinized mouse enamel or dentin; and (2) compare wild-type (WT), amelogenin null (AmelxKO), and matrix metalloproteinase-20 null (Mmp20KO) enamel and dentin phenotypes using micro-CT and nanoindentation. METHODS: Enamel incisor surfaces of WT, AmelxKO, and Mmp20KO mice were treated with SEB with and without sodium hypochlorite and tested for SBS. Incisor dentin was also treated with SEB and tested for SBS. These surfaces were further examined by scanning electron miscroscopy. Micro-CT and nanoindentation analyses were performed on mouse dentin and enamel. Data were analyzed for significance by analysis of variance. RESULTS: Deproteinization did not improve SBS of SEB to these AI-affected enamel surfaces. SBS of AmelxKO teeth was similar in dentin and enamel; however, it was higher in Mmp20KO dentin. The nanohardness of knockout enamel was significantly lower than WT, while knockout dentin nanohardness was not different from WT. CONCLUSIONS: Using animal amelogenesis imperfecta models, enamel sodium hypochlorite deproteinization of hypoplastic and hypoplastic-hypomaturation enamel did not increase shear bond strength, while removal of the defective enamel allowed optimal dentin bonding.
Asunto(s)
Amelogénesis Imperfecta/patología , Recubrimiento Dental Adhesivo , Esmalte Dental/ultraestructura , Dentina/ultraestructura , Incisivo/ultraestructura , Adhesividad , Amelogenina/genética , Animales , Resinas Compuestas/química , Esmalte Dental/efectos de los fármacos , Materiales Dentales/química , Dentina/efectos de los fármacos , Dureza , Incisivo/efectos de los fármacos , Metaloproteinasa 20 de la Matriz/genética , Ratones , Ratones Noqueados , Microscopía Electrónica de Rastreo , Oxidantes/farmacología , Fenotipo , Cementos de Resina/química , Resistencia al Corte , Hipoclorito de Sodio/farmacología , Estrés Mecánico , Propiedades de Superficie , Microtomografía por Rayos X/métodosRESUMEN
Asthma and dental caries are common chronic health conditions of childhood. The aim of this study was to determine if severity of bronchial asthma is a risk factor for early childhood caries. Asthmatic children aged 71 months or younger were examined for their plaque and caries status and were compared with controls matched for age, sex and socioeconomic status. The results showed that asthmatics as a group had a lower DMFT score than the control group. New asthma management and educational programs may be having a positive spillover effect to the dental arena.
RESUMEN
Asthma and dental caries are common chronic health conditions of childhood. The aim of this study was to determine if severity of bronchial asthma is a risk factor for early childhood caries. Asthmatic children aged 71 months or younger were examined for their plaque and caries status and were compared with controls matched for age, sex and socioeconomic status. The results showed that asthmatics as a group had a lower DMFT score than the control group. New asthma management and educational programs may be having a positive spillover effect to the dental arena.
Asunto(s)
Asma/complicaciones , Índice CPO , Caries Dental/complicaciones , Placa Dental/complicaciones , Estudios de Casos y Controles , Niño , Preescolar , Pruebas de Actividad de Caries Dental , Humanos , Lactante , Análisis por Apareamiento , Índice Periodontal , Valores de Referencia , Factores de RiesgoRESUMEN
The purpose of this study was to determine graduating dental students' perceptions about their training and experience in examination and treatment of infants and their plans to examine infants upon graduation. A survey was distributed to dental students graduating from Pennsylvania dental schools in 2007 and 2008. Of the returned surveys, 47.9 percent correctly identified 12 months as the recommended age for the first dental exam. Sixty-five percent of responders felt they would be comfortable performing exams on young children. This study's primary objective was to test the association between performance of a clinical exam in a young child, enjoyment of clinical and didactic pediatric dental experience, plans for additional training in pediatric dentistry and willingness to see children younger than two years old in practice. Performing a clinical exam on a young child was associated to willingness to see children younger than two years of age in practice. Early exposure (lecture or clinical) to young pediatric patients while in dental school was significantly associated to perceived comfort with oral exam of young patients but not to reported willingness to see them in practice.
Asunto(s)
Actitud del Personal de Salud , Atención Dental para Niños/psicología , Cuidado del Lactante/psicología , Odontología Pediátrica/educación , Estudiantes de Odontología , Humanos , Lactante , Pennsylvania , Encuestas y CuestionariosRESUMEN
Phentolamine mesylate, at dosages from 0.4 to 0.8 mg in adults and adolescents and at dosages from 0.2 to 0.4 mg in children aged 4 to 11 years, has been proven to be safe and effective for the reversal of soft tissue anesthesia (lip and tongue numbness) and the associated functional deficits resulting from a local dental anesthetic injection containing a vasoconstrictor. Its ability to block a-adrenergic receptors on blood vessels induces vasodilation and enhances the redistribution of the local anesthetic away from the injection site. The low dosages administered for dental local anesthetic reversal in all likelihood accounts for the lack of significant cardiovascular effects that are associated with the medical use of the drug for hypertensive conditions associated with catecholamine excess.
Asunto(s)
Antagonistas Adrenérgicos alfa/farmacología , Anestesia Dental/efectos adversos , Anestesia Local/efectos adversos , Anestésicos Locales/antagonistas & inhibidores , Hipoestesia/tratamiento farmacológico , Fentolamina/farmacología , Adolescente , Antagonistas Adrenérgicos alfa/uso terapéutico , Adulto , Periodo de Recuperación de la Anestesia , Anestesia Dental/métodos , Anestésicos Locales/efectos adversos , Niño , Atención Dental para Niños/métodos , Humanos , Hipoestesia/inducido químicamente , Lidocaína/efectos adversos , Lidocaína/antagonistas & inhibidores , Labio/efectos de los fármacos , Labio/inervación , Fentolamina/uso terapéutico , Lengua/efectos de los fármacos , Lengua/inervación , Vasoconstrictores/efectos adversosRESUMEN
The major protein components of the enamel matrix include the most abundant amelogenin proteins as well as less plentiful proteins such as enamelin and ameloblastin. The enamel defect in amelogenesis imperfecta (Al) generally results in enamel that is too thin (hypoplastic) or too soft (hypocalcification or hypomaturation). Previous reports indicate that mutations in the human enamelin gene (ENAM) cause hypoplastic Al through autosomal-dominant inheritance patterns and patients may also exhibit an anterior open bite. Although crown resorption of unerupted teeth occurs more frequently in Al patients, this finding has not been previously associated with known ENAM mutations. The purpose of this article was to report the genotype-phenotype correlations for a 9-year, 11-month-old boy with a homozygous ENAM mutation (c.1258_1259insAG).
Asunto(s)
Amelogénesis Imperfecta/genética , Proteínas del Esmalte Dental/genética , Estudios de Asociación Genética , Niño , Codón sin Sentido , Análisis Mutacional de ADN , Humanos , Masculino , Mordida Abierta/genética , Linaje , Resorción Dentaria/genéticaRESUMEN
The sideroblastic anemias comprise a heterogeneous group of acquired and congenital disorders which that have in common: (1) anemia; (2) the presence of ring sideroblasts in the bone marrow; and (3) impaired heme biosynthesis. Elevation in iron levels is secondary to a deficiency in mitochondrial physiology. Patients exhibit mild to moderate hemolysis due to peripheral red blood cell destruction, and often require regular blood transfusions. The purpose of this case report was to describe the dental management of a child with congenital sideroblastic anemia--a rare hematologic disorder--and to emphasize how important it is for pediatric dentists to be cognizant of a patient's hematologic profile before attempting to perform any dental procedure. The timing of the patient's transfusions regarding the scheduling of dental care is crucial for successful management and anticipation of possible complications. Preventive dentistry should be a hallmark of dental management for these children.
Asunto(s)
Anemia Sideroblástica/congénito , Atención Dental para Enfermos Crónicos , Anestesia General , Profilaxis Antibiótica , Transfusión Sanguínea , Preescolar , Femenino , HumanosRESUMEN
Pediatric patients who are comatose may develop a neuropathological chewing or clenching reflex that results in self-inflicted injury to the soft tissues of the oral cavity. An early and quick response to these problems may minimize the extent of soft tissue trauma. The use of a stock fluoride tray in the hospital management of a pediatric patient who was neurologically impaired and unconsciously traumatizing his oral soft tissues is described. This treatment modality may serve as an initial or interim device in managing pediatric patients with uncoordinated mandibular movements or clenching. In some instances, given the sometimes self-limiting nature of this problem, fluoride trays may serve as the sole mode of treatment
Asunto(s)
Coma/complicaciones , Protectores Bucales , Boca/lesiones , Enfermedades Neurodegenerativas/complicaciones , Automutilación/prevención & control , Niño , Coma/etiología , Atención Dental para la Persona con Discapacidad/instrumentación , Fluoruros/administración & dosificación , Humanos , Masculino , Masticación , Automutilación/etiología , Traumatismos de los Tejidos Blandos/prevención & control , Lengua/lesionesRESUMEN
Management of patients with autoimmune disease can present a challenge for clinicians. Combinations of autoimmune disorders carry a worse prognosis and are often difficult to diagnose. Evans syndrome is a rare hematologic disorder characterized by the concurrent presentation of autoimmune hemolytic anemia and immune thrombocytopenic purpura. This paper reports the first case of the dental management of a young patient with Evans, discusses the current literature surrounding the differential diagnosis and treatment of Evans syndrome, and suggests a guide for the oral medicine, pediatric dentist, or hospital dental clinician when treating these patients.
Asunto(s)
Anemia Hemolítica Autoinmune , Atención Dental para Enfermos Crónicos/métodos , Caries Dental/terapia , Hemorragia Posoperatoria/prevención & control , Púrpura Trombocitopénica Idiopática , Extracción Dental , Adolescente , Femenino , Humanos , SíndromeRESUMEN
Periodic fever syndromes in children can present with orofacial manifestations which contribute to the formulation of a differential diagnosis. Because of the early onset of oral lesions in these syndromes, the oral medicine practitioner may be required to assist in their diagnosis and management. The periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome has been classified as a type of periodic fever syndrome ocurring in early childhood. This article presents a review of the published literature on this entity and summarizes current therapeutic options.
Asunto(s)
Fiebre/complicaciones , Linfadenitis/complicaciones , Faringitis/complicaciones , Estomatitis Aftosa/complicaciones , Analgésicos/uso terapéutico , Antiinflamatorios/uso terapéutico , Niño , Preescolar , Cimetidina/uso terapéutico , Diagnóstico Diferencial , Fiebre/diagnóstico , Fiebre/tratamiento farmacológico , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Linfadenitis/diagnóstico , Linfadenitis/tratamiento farmacológico , Periodicidad , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Recurrencia , Estomatitis Aftosa/diagnóstico , Estomatitis Aftosa/tratamiento farmacológico , SíndromeRESUMEN
Tumor necrosis factor-related apoptosis inducing ligand (TRAIL) is an important immunomodulatory factor that may play a role in the structural changes observed in the asthmatic airways. In vitro as well as in vivo studies have evidenced a dual role for TRAIL: it can either function as a pro- or anti-inflammatory cytokine on inflammatory cells, participating in the initiation and resolution of inflammatory and immune responses. TRAIL is expressed in the airways by inflammatory cells infiltrated in the bronchial mucosa, as well as by structural cells of the airway wall including fibroblasts, epithelial, endothelial, and smooth muscle cells. By releasing TRAIL, these different cell types may then participate in the increased levels of TRAIL observed in bronchoalveolar lavage fluid from asthmatic patients. Taken together, this suggests that TRAIL may play a role in inflammation in asthma. However, concerning its role is dual in the modulation of inflammation, further studies are needed to elucidate the precise role of TRAIL in the airways.
Asunto(s)
Glicoproteínas de Membrana , Sistema Respiratorio , Factor de Necrosis Tumoral alfa , Proteínas Reguladoras de la Apoptosis , Asma , Vasos Sanguíneos , Epitelio , Fibroblastos , Regulación de la Expresión Génica , Glucocorticoides , Humanos , Glicoproteínas de Membrana/genética , Glicoproteínas de Membrana/fisiología , Músculo Liso , Regiones Promotoras Genéticas , Ligando Inductor de Apoptosis Relacionado con TNF , Factor de Necrosis Tumoral alfa/genética , Factor de Necrosis Tumoral alfa/fisiologíaRESUMEN
Asthma is a chronic lung disease exhibiting airway obstruction, hyperresponsiveness, and inflammation, characterized by the infiltration of eosinophils into the airways and the underlying tissue. Prolonged eosinophilic inflammation depends on the balance between the cell's inherent tendency to undergo apoptosis and the local eosinophil-viability enhancing activity. TRAIL, a member of the TNF family, induces apoptosis in most transformed cells; however, its role in health and disease remains unknown. To test the hypothesis that Ag-induced inflammation is associated with TRAIL/TRAIL-R interactions, we used a segmental Ag challenge (SAC) model in ragweed-allergic asthmatics and nonasthmatic patients and analyzed bronchoalveolar lavage (BAL) material for 2 wk. In asthmatic patients, the level of TRAIL in BAL fluid dramatically increased 24 h after SAC, which significantly correlated with BAL eosinophil counts. Immunohistochemical analysis of bronchial biopsies from asthmatic patients demonstrated that TRAIL staining was increased in epithelial, airway smooth muscle, and vascular smooth muscle cells and throughout the interstitial tissue after SAC. This was confirmed by quantitative immunocytochemical image analysis of BAL eosinophils and alveolar macrophages, which demonstrated that expression levels of TRAIL and DcR2 increased, whereas expression levels of the TRAIL-Rs DR4 and DR5 decreased in asthmatic subjects after SAC. We also determined that TRAIL prolongs eosinophil survival ex vivo. These data provide the first in vivo evidence that TRAIL expression is increased in asthmatics following Ag provocation and suggest that modulation of TRAIL and TRAIL-R interactions may play a crucial role in promoting eosinophil survival in asthma.