Prognostic and survival factors in head and neck extra-nodal non-Hodgkin's lymphoma.

OBJECTIVE: To make a clinical-biological characterization of this pathology and assess the survival of these patients and the associated prognostic factors. STUDY DESIGN: A retrospective observational study was designed to identify primary extranodal non-Hodgkin lymphomas of the head and neck diagnosed between January 1, 2005, and January 1, 2016. Cases were considered if they presented with a single tumor in situ or if the extranodal component was clinically predominant. RESULTS: A total of 145 patients were included. Localized stages (I-II) were present in 69.3%. Overall, 91.8% were B-cell phenotype, with diffuse large B-cell lymphoma being the most frequent. Overall, 78% of patients were treated with immunochemotherapy. The overall survival at 3 and 5 years was 75% and 73%, respectively. Adverse prognostic factors were: low hemoglobin, elevated ß2-microglobulin, and lactate dehydrogenase (LDH) levels, Eastern Cooperative Oncology Group (ECOG), stage III/IV, and B symptomatology at diagnosis. The progression-free survival at 3 and 5 years was 71% and 68%. Risk factors for relapse were high ß2-microglobulin, high LDH, and stage III-IV at diagnosis. CONCLUSIONS: These pathologies show a good response to treatment with immuno-polychemotherapy. Factors associated with a worse prognosis included low hemoglobin, elevated levels of ß2-microglobulin and LDH, elevated ECOG, stage III/IV, and B symptomatology at diagnosis.

Management of a crown-root fracture: A novel technique with interdisciplinary approach.

Anterior teeth with subgingival fractures require a complex treatment plan that addresses biologic, functional and aesthetic factors. This case report describes the management of a crown-root fractured maxillary left central incisor. An interdisciplinary approach was used to restore the tooth due to the complex nature of the treatment. Orthodontic extrusion was performed to move the fracture line above the alveolar bone and periodontal surgery to recontour the altered gingival margin. Finally, the incisor was restored performing a root canal retreatment with a fiber post and a full ceramic crown. The treatment resulted in secured periodontal health and good aesthetics. Key words:Crown-root fracture, orthodontic extrusion, crown lengthening, root canal retreatment, full ceramic crown.

Management of large class II lesions in molars: how to restore and when to perform surgical crown lengthening?

The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.