Oral varix: a review.

BACKGROUND: Ageing produces several changes on the oral cavity, and oral varix (OV) is among the most common, and they are related with some medical diseases; however, this association is not clear. OBJECTIVE: The aim of this article is to offer a review of OV, regarding aetiology, clinical and histological features, associated factors, treatment and its clinical significance. CONCLUSION: Except for a higher incidence of OV in elder individuals, there is limited evidence that supports its relationship with medical conditions such us cardiovascular diseases or portal hypertension. Also, there is no consensus regarding its pathogenesis, but the hemodynamic theory embodies the most comprehensive approach. The high prevalence in elderly people stresses the need for regular oral examination, but more detailed studies regarding OV in relation to systemic diseases are needed.

Characterization of maxillary central incisor: novel crown-root relationships.

OBJECTIVES: The periodontal biotype includes crown features of the maxillary central incisor (MCI), whereas root measures have been less studied. The aim of our study was to morphologically characterize MCI and search relationships between crown and root measures. MATERIAL AND METHODS: One hundred-fifty MCIs were used. On each tooth, several crown and root reference points were marked and the following measures were done: On crown: mesio-distal (MD = major, md = minor), axial (crown length, cervical convexity) and buccolingual diameters (Cbl); On root: mesio-distal (Rmd) and buccolingual diameters (Rbl); and tooth length. A ratio between md and MD was made in order to assess dental forms. Root diameter prediction was assessed by means of multiple and single linear regression analyses, with variable selection by backward method. Reliability of measurements was estimated by the Pearson correlation coefficient. RESULTS: Dental form groups were: Stout type 56.67 %, Intermediate type 22.67 %, and Strangled type 20.67 %. A significative association was found between Rbl and Cbl (p = 0,000), Rmd with md (p = 0.000), and Rmd with MD (p = 0.000). The results allow predicting root diameters through crown measures. CONCLUSIONS: There is a direct relationship between crown and root features, which allows the prediction of root diameters with a high accuracy (95 %), regardless of tooth form. CLINICAL RELEVANCE: The morphometric data assess tooth diameters more accurately and could improve treatment planning, offering a more comprehensive approach to the periodontal biotype concept.

Characterization of Chronic Mechanical Irritation in Oral Cancer.

Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% (n = 218) presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa.

Tinción con azul de toluidina en biopsia dirigida de lesiones displásicas de la mucosa bucal: informe de casos clínicos / Toluidine blue guided biopsy of dysplastic lesions of the oral mucosa: clinical cases report

Objetivo: Los desórdenes de mucosa bucal potencialmente malignos pueden presentar áreas displásicas. En estos casos, la biopsia es un procedimiento imprescindible para un correcto diagnóstico. La inspección visual y la palpación, como método de selección del área de biopsia, ofrecen sensibilidad y especificidad adecuadas pero mejorables. El objetivo de este artículo es presentar una serie de casos clínicos en los que se describen el empleo y la interpretación de la tinción vital con azul de toluidina como método complementario para contribuir a una mejor elección del área de biopsia. Casos clínicos: Se trata de siete casos de lesiones con sospecha de displasia epitelial en mucosa bucal. En cada uno se detalla la correlación de las áreas teñidas con las manifestaciones clínicas y con el diagnóstico de displasia. Además, se muestran patrones de tinción considerados falsos positivos. En la interpretación de la tinción positiva, se tuvieron en cuenta el aspecto superficial y el color de la lesión teñida. El empleo combinado de inspección, palpación y tinción vital podría constituir un procedimiento integral de utilidad para obtener mayor precisión en la determinación del sitio de biopsia en comparación con los mismos procedimientos aplicados de manera individual. En la interpretación de la tinción positiva con azul de toluidina deberían considerarse el aspecto superficial y el color de la lesión teñida (AU)

Aim: Potentially Malignant Disorders in the oral cavity can present dysplastic areas. In these cases, the biopsy is an essential procedure for a correct diagnosis. Visual inspection and palpation, are adequate methods to select the area for the biopsy, however there is margin for improvement. The objective of this article is to present a series of clinical cases in which the use and interpretation of vital staining with Toluidine Blue is described as a complementary method to contribute to a better choice of the biopsy area. Clinical cases: Seven clinical cases that presented lesions with suspected epithelial dysplasia in the oral mucosa were presented. The correlation of the stained areas with the clinical manifestations and with the diagnosis of dysplasia is detailed in each case. Staining patterns considered false positives are also shown. In the interpretation of the positive staining, the superficial appearance and color of the stained lesion were considered. The combined use of inspection, palpation and vital staining could constitute a useful comprehensive procedure to obtain greater precision in determining the biopsy site in relation to the same procedures applied individually. In the interpretation of the positive staining with Toluidine Blue, the superficial appearance and color of the stained lesion should be considered (AU)