RESUMO
RATIONALE: Endodontic surgery, which includes apex resection, retro-fill and some regeneration procedures, is a traditional way to deal with apex fenestration. The endodontic surgery could bring large flap, curtate root length, non-healing mucosa and soft tissue deficiency in the apex area. Other treatment options might be considered according to different etiological factors. Mucogingival surgery provides some ideas in accumulation of soft and hard tissues, especially some unique methods such as "tunnel technique" bringing us a view of minimal invasive surgery approach. A novel surgery named "apical tunnel surgery" was reported here to resolve a root apex exposure with the tunnel-like technique. PATIENT CONCERNS: A young female complained about root exposure of upper right anterior tooth without history of trauma or orthodontic treatment. DIAGNOSIS: The intraoral examination revealed a buccal root apex exposure about 3mm in diameter of #12 (FDI teeth numbering system). The tooth was slightly dark with Class 1 mobility. The periodontal situation was good and the occlusion check revealed no traumatic bite on #12. The cone-beam computed tomography (CBCT) showed a bone fenestration from the buccally lower 1/2 root surface to the apex and bone absorption around the apex. It also revealed a bone contour deficiency in #12 area. INTERVENTIONS: Root canal treatment, root surface debridement, and soft tissue combined with hard tissue accumulation were carried out in one tunnel-like surgery. OUTCOMES: Examination of 12-month follow-up showed a healed and thickened mucosa in the buccally apical region and CBCT showed the continuous lamina dura occupied the buccal aspect of #12 root apex. LESSONS: This new apical tunnel surgery provided soft and hard tissue accumulation in one minimal invasive way in the apex exposure case caused by bone fenestration and thin mucosa.
Assuntos
Ápice Dentário , Humanos , Feminino , Ápice Dentário/cirurgia , Ápice Dentário/diagnóstico por imagem , Apicectomia/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Adulto , Mucosa Bucal/cirurgia , Mucosa Bucal/transplanteRESUMO
BACKGROUND: Head and neck carcinoma of unknown primary (CUP) represents a challenging diagnostic process when standard work-up fails to identify the primary tumour site. The aim of this systematic review and meta-analysis was to evaluate the diagnostic utility and complication profile of transoral robotic surgery (TORS) tongue base mucosectomy (TBM) in the management of CUP. PATIENTS AND METHODS: An electronic database search was performed in the EMBASE, MEDLINE, PubMed and Cochrane databases. A meta-analysis of proportions was performed to obtain an estimate of the overall proportion for the detection and complication rates. RESULTS: Nine studies representing 235 patients with CUP who had TORS TBM were included in the final analysis. The overall pooled tumour detection rate was 66.2% [95% confidence interval (CI) 56.1-75.8]. The incidence of tumour detection in human papilloma virus (HPV)-positive cases (81.5%, 95% CI 60.8-96.4) was significantly higher than HPV-negative cases (2.3%, 95% CI 0.00-45.7). Weighted overall complication rate was 11.4% (95% CI 7.2-16.2). The majority were grade I or II (80%) according to the Clavien-Dindo classification. CONCLUSIONS: This meta-analysis suggests TORS to be safe and effective in localising the primary tumour site in patients with CUP. While the current data supports the use of TORS in patients who are HPV positive, larger numbers of HPV-negative cases are required to determine the true diagnostic effect with TORS before any valid conclusions can be inferred in this particular subgroup. Further research should focus on high quality prospective trials with stringent methodological work-up to minimise heterogeneity and allow for more accurate statistical analysis.
Assuntos
Neoplasias Primárias Desconhecidas , Procedimentos Cirúrgicos Robóticos , Humanos , Neoplasias Primárias Desconhecidas/cirurgia , Neoplasias Primárias Desconhecidas/patologia , Procedimentos Cirúrgicos Robóticos/métodos , Prognóstico , Neoplasias da Língua/cirurgia , Neoplasias da Língua/patologia , Mucosa Bucal/patologia , Mucosa Bucal/cirurgiaRESUMO
PURPOSE: To investigate the effect of mid-buccal peri-implant keratinized mucosa width (KMW) ≥2 mm or peri-implant KMW >0 mm and <2 mm on the long-term outcomes of peri-implantitis reconstructive treatment. MATERIALS AND METHODS: Twenty-nine patients (40 implants; mean follow-up: 9.2 ± 1.4 years) with at least one implant affected by peri-implantitis and surgically treated through a reconstructive procedure followed by a submerged healing were included. Patients were categorized according to their initial KMW: Group 1 (KMW ≥2 mm) and Group 2 (KMW >0 mm and <2 mm). Peri-implant clinical and radiographic parameters and a dedicated composite outcome were assessed at different follow-up visits during supportive peri-implant therapy for up to 10 years. Regression analyses were utilized to identify possible risk/predictive indicators for probing pocket depth (PPD) change and treatment success at the latest follow-up. RESULTS: The mean PPD did not exhibit any statistical difference from the baseline to the latest follow-up between the groups at both patient and implant levels. Long-term treatment success was 46.6% (Group 1) and 42.6% (Group 2) at patient level, it was 42.8% (Group 1) and 33.3% (Group 2), respectively, at implant level (p > 0.05). Group 1 demonstrated significantly higher vertical defect depth reduction than Group 2 (p = 0.018). Presence of buccal bony wall and mean PPD at the baseline were found to be associated with mean PPD change, while KMW at 6 months following surgery was identified as the only significant indicator for treatment success (p < 0.05). CONCLUSION: Implants with KMW ≥2 mm did not present significantly better long-term clinical outcomes following reconstructive therapy than those exhibiting KMW >0 mm and <2 mm. However, KMW values at the end of healing phase following a submerged approach had a significant impact on long-term treatment success.
Assuntos
Peri-Implantite , Humanos , Peri-Implantite/etiologia , Peri-Implantite/cirurgia , Peri-Implantite/diagnóstico por imagem , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Seguimentos , Resultado do Tratamento , Idoso , Implantes Dentários/efeitos adversos , Queratinas , Adulto , Mucosa Bucal/cirurgia , Implantação Dentária Endóssea/métodos , Implantação Dentária Endóssea/efeitos adversosRESUMO
This article highlights the importance of proper suturing of mucosa, gingiva, and skin after surgical procedures and trauma. Several factors play a role in promoting good healing, including optimal tension on the sutured wound, adequate blood flow, and careful selection of suture materials. The selected suture material depends on various factors, such as type of tissue, location of the wound, and healing time. Different suture techniques are discussed, including interrupted sutures, continuous sutures, horizontal and vertical mattress sutures, each with their own specific applications and benefits. Skillfulness in suture techniques and appropriate material selection contribute to effective wound healing and optimal outcomes.
Assuntos
Procedimentos Cirúrgicos Bucais , Técnicas de Sutura , Suturas , Cicatrização , Humanos , Procedimentos Cirúrgicos Bucais/métodos , Cicatrização/fisiologia , Gengiva/cirurgia , Mucosa Bucal/cirurgiaRESUMO
In clinical practice, an innovative laser technology that provides contactless preparation of soft tissues with a wavelength of 445 nm has been introduced. This study aimed to investigate the morphological changes in the oral mucosa when exposed to laser radiation at a wavelength of 445 nm in the ablation mode.An experimental study was conducted to analyze the dynamics of reparative regeneration in the wound caused by that particular type of radiation, utilizing the procedure of lower lip frenuloplasty as an illustration. 48 sexually mature male laboratory rats were chosen as the research object. The procedure of preparing the oral vestibule was executed by employing a contactless laser beam with a wavelength of 445 nm and a power of 0.7 W in continuous mode (CW) and an uninitiated fiber.Histological examination showed that 25 min after the surgery, there were large areas of coagulation necrosis in the oral mucosa in the area affected by the blue laser. In 48 h, the area of necrosis decreased both in size and depth. By the 7th day after the surgery, the necrotic masses had grown into the connective tissue, while marginal regeneration of the epithelium was noted. By the 14th day, the wound surface was completely epithelialized, represented by fibrous scar tissue. Clinically, around the mandibular incisors, there was a wide area of attached keratinized gingiva.The findings of histological examination indicate a necrosis of coagulation type in the region of tissue ablation and also show the absence of phase II of the inflammatory response (the stage of exudation), which expedites the process of epithelialization of the oral mucosa wound.
Assuntos
Mucosa Bucal , Regeneração , Cicatrização , Animais , Mucosa Bucal/efeitos da radiação , Mucosa Bucal/cirurgia , Mucosa Bucal/patologia , Masculino , Projetos Piloto , Ratos , Cicatrização/efeitos da radiação , Regeneração/efeitos da radiação , Terapia a Laser/métodos , Terapia a Laser/instrumentação , NecroseRESUMO
OBJECTIVE: To assess the feasibility of utilizing the keystone design perforator island flap (KDPIF) for the repair of small to medium-sized defects in the buccal mucosa and floor of mouth (cT1-2 stage tumor). STUDY DESIGN: We conducted a retrospective analysis of eight patients who underwent KDPIF to address oral defects at the Affiliated Hospital of Qingdao University between June 2021 and September 2022. Patient information, including medical history, defect site, flap size, operative time, hospital stay, complications, and postoperative recovery of oral function, was comprehensively evaluated. RESULTS: Eight patients (6 females and 2 males) underwent reconstruction using KDPIF. The mean operation time was 58.5 minutes (55-63 minutes), with an average length of stay of 3.5 days (3-5 days). None of the 8 cases (100%) exhibited flap splitting necrosis or infection. Moreover, no scar contracture was observed, and oral functions, including the degree of opening, type of opening, tongue mobility, speech function, and swallowing function, were successfully restored. One patient (12.5%) experienced bleeding from the incision on the first postoperative day, but following compression, hemostasis was achieved, and the incision healed well. CONCLUSIONS: KDPIF demonstrates technical feasibility and suitability for repairing small to medium-sized buccal mucosa and floor of mouth defects (cT1-2).
Assuntos
Mucosa Bucal , Neoplasias Bucais , Retalho Perfurante , Procedimentos de Cirurgia Plástica , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/transplante , Mucosa Bucal/cirurgia , Estudos Retrospectivos , Retalho Perfurante/transplante , Adulto , Neoplasias Bucais/cirurgia , Idoso , Procedimentos de Cirurgia Plástica/métodos , Soalho Bucal/cirurgia , Estudos de Viabilidade , Resultado do TratamentoRESUMO
OBJECTIVE: Resection of tumors of oral cavity usually causes short- or long-term sequelae such as chewing, speech and swallowing impairment. To preserve this function it is necessary to maintain the lining of the oral cavity, the mobility and sensitivity of the tongue. Reconstructive options for oral mucosal defects resulting from tumor resection included primary closure, mucosal and skin grafts, pedicle and microvascular free flaps, and dermal matrix. STUDY DESIGN: Retrospective study on patients undergoing reconstruction of intraoral defects, after removal of T1, T2 malignant tumors, by placement of bilayer dermal matrix. METHODS: From 2021 to 2022, 47 patients with oral mucosa defects after removal of squamous cell carcinoma were treated. All patients were affected by a T1-T2 squamous cell carcinoma. For each patient, data were collected regarding the site of the disease, the initial staging, the size of the surgical defect, the complications and the outcome months after the operation. RESULTS: In all treated cases the surgical defect involved the mucosa of the cheek, the oral floor or the tongue with an average size of 5.45cm2. Patients who underwent this type of reconstruction benefited from excellent healing of intraoral wounds and good restoration of oral function 6 months after surgery. Out of the total number of patients, membrane attachment failure was reported in only two cases. CONCLUSION: As emerges from the data reported in our study, the dermal matrix represents a valid alternative in oncological reconstructive surgery for small/medium-sized intraoral mucosal defects because it allows re-epithelialization of the wound.
Assuntos
Carcinoma de Células Escamosas , Mucosa Bucal , Neoplasias Bucais , Procedimentos de Cirurgia Plástica , Humanos , Estudos Retrospectivos , Masculino , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Feminino , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Idoso , Mucosa Bucal/cirurgia , Mucosa Bucal/patologia , Adulto , Idoso de 80 Anos ou mais , Estadiamento de NeoplasiasRESUMO
OBJECTIVE: The reconstruction of composite defects in the oral and maxillofacial region using vascularized fascial flaps, such as the fibular, iliac, and temporal fascial flaps, has gained increasing attention among surgeons. However, there remains uncertainty regarding the suitability of fascial flaps as transplants, as well as their healing processes and outcomes, due to their non-mucosal nature. This study aims to comprehensively assess the biological aspects of vascularized fascial flaps at clinical, histological, and genetic levels, with the goal of providing essential biological references for their clinical application. STUDY DESIGN: This study enrolled three patients who underwent reconstruction of combined oral mucosa-mandibular defects using fibular vascularized fascial flaps between 2020 and 2023. Data regarding changes in the appearance of the fascial flaps, bulk-RNA sequencing, and histological slices of initial fascia, initial gingiva, and transformed fascia were collected and analyzed. RESULTS: Within three months, the fascial flaps exhibited rapid epithelial coverage and displayed distinct characteristics resembling mucosa. High-throughput RNA sequencing analyses and histological slices revealed that the transformed fascia exhibited tissue structures similar to mucosa and demonstrated unique advantages in promoting blood vessel formation and reducing scarring through the high-level expression of relevant genes. CONCLUSION: These findings emphasize the potential and feasibility of utilizing vascularized fascial flaps for oral mucosa reconstruction, establishing their unique advantage as transplant materials, and providing significant biological information and references for their selection and clinical application.
Assuntos
Fáscia , Mucosa Bucal , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Humanos , Mucosa Bucal/transplante , Mucosa Bucal/patologia , Mucosa Bucal/cirurgia , Fáscia/transplante , Masculino , Procedimentos de Cirurgia Plástica/métodos , Feminino , Retalhos Cirúrgicos/transplante , Mandíbula/cirurgia , Mandíbula/patologia , Pessoa de Meia-Idade , AdultoRESUMO
OBJECTIVE: This study compared a dual-wavelength diode laser and an Er, Cr:YSGG laser in oral soft tissue incisions to determine the most effective and safest laser system at the histopathological level. METHODOLOGY: The (810 and 980 nm) dual-wavelength diode laser was used at 1.5 W and 2.5 W (CW) power settings, and the (2780 nm) Er, Cr:YSGG laser was used at 2.5 W and 3.5 W (PW) power settings. Both laser systems were used to incise the tissues of freshly dissected sheep tongue pieces to obtain the following histopathological criteria: epithelial tissue changes, connective tissue changes, and lateral thermal damage extent by optical microscopy. RESULTS: The epithelial and connective tissue damage scores were significantly higher in the dual-wavelength diode laser groups than in the Er, Cr:YSGG laser groups (P<0.001), and there was a significant difference between some groups. The extent of lateral thermal damage was also significantly higher in the diode laser groups than in the Er, Cr: YSGG laser groups (P<0.001), and there was a significant difference between groups. Group 2 (2.5 W) of the diode laser was the highest for all three criteria, while group 3 (2.5 W) of the Er, Cr:YSGG laser was the lowest. CONCLUSION: The Er, Cr:YSGG laser with an output power of 2.5 W is, histologically, the most effective and safest laser for oral soft tissue incision. The dual-wavelength diode laser causes more damage than the Er, Cr:YSGG laser, but it can be used with a low output power and 1 mm safety distance in excisional biopsy.
Assuntos
Lasers Semicondutores , Lasers de Estado Sólido , Margens de Excisão , Língua , Animais , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Língua/cirurgia , Língua/patologia , Reprodutibilidade dos Testes , Ovinos , Tecido Conjuntivo/patologia , Epitélio/patologia , Valores de Referência , Procedimentos Cirúrgicos Bucais/métodos , Mucosa Bucal/patologia , Mucosa Bucal/cirurgia , Estatísticas não Paramétricas , Terapia a Laser/métodos , Terapia a Laser/instrumentaçãoRESUMO
OBJECTIVES: The aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. METHODS: The study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. RESULTS: 105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 - max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. CONCLUSIONS: Our findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. CLINICAL SIGNIFICANCE: This study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.
Assuntos
Mucosa Bucal , Nylons , Técnicas de Sutura , Suturas , Cicatrização , Humanos , Estudos Prospectivos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Mucosa Bucal/microbiologia , Mucosa Bucal/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Complicações Pós-Operatórias , Satisfação do Paciente , Adulto Jovem , Idoso , Adolescente , Extração Dentária , Dor Pós-Operatória , Dente Serotino/cirurgia , Estudos de Coortes , Resultado do TratamentoRESUMO
BACKGROUND: Squamous Cell Carcinoma (SCC) of the buccal mucosa and gingiva accounts for approximately 10% of oral and pharyngeal cancers diagnosed in the United States each year, with a disproportionally higher incidence in individuals of South Asian descent. However, little has been documented regarding trends pertaining to overall survival. Thus, this research serves to identify predictors of survival and determine if overall survival (OS) differs for South Asians compared to other races once they develop non-metastatic buccal mucosa or gingiva squamous cell carcinoma. METHODS: A population-based, cohort study of patients registered in the National Cancer Database® (NCDB) between the years 2004-2016 was performed. Kaplan-Meyer Survival Curves were executed to examine overall survival, while univariable (UVA) and multivariable analysis (MVA) was performed to determine the effect of multiple variables on OS. RESULTS: South Asians had longer median OS at 88.7 months, compared to 58.6 months and 38.3 months for Caucasians and African Americans respectively (p<0.001). In UVA, race was highly significant, but when the cohort was selected to include only those who had undergone surgical resection, no statistically significant difference remained. On MVA, lack of surgery, older age, higher grade, higher T and N stage, use of chemotherapy, higher comorbidity scores were associated with worse OS, but race was not significant. CONCLUSION: South Asians in the US with non-metastatic buccal mucosa or gingiva SCC have better OS compared to Caucasians or African Americans, likely due to younger age at diagnosis (median 59 vs. 71 and 62 years old) and more frequent surgical resection (75% vs. 72% and 64%). In MVA, South Asians have similar OS as Caucasians.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Estados Unidos/epidemiologia , Mucosa Bucal/cirurgia , Mucosa Bucal/patologia , Estudos de Coortes , Prognóstico , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/patologia , Estudos RetrospectivosRESUMO
The aim of this paper was to describe a modification to an old method to enhance the vermillion in adult cleft patients. We present ten consecutive patients who requested enhancement of the upper lip vermillion. The technique involves a continuous V plasty within the non-visible mucosa to elevate the vermillion. Each V incision is of a different size to match the defect. Then the V flaps are sutured to one another but the donor defect is left open to epithelialise. Adjunctive procedures are possible at the same time. There were no major complications but one patient was over corrected and needed reduction of mucosa. The technique offers a permanent enhancement of the vermillion and is a safe alternative to other methods of lip augmentation including fillers.
Assuntos
Fenda Labial , Procedimentos de Cirurgia Plástica , Adulto , Humanos , Fenda Labial/cirurgia , Lábio/cirurgia , Retalhos Cirúrgicos/cirurgia , Mucosa Bucal/cirurgiaRESUMO
OBJECTIVE: To evaluate the long-term outcomes of linear commissuroplasty and linear skin closure with a focus on commissural migration. DESIGN: Retrospective study. PATIENTS: Individuals who underwent transverse facial cleft repair at a single institution between 2004 and 2021. INTERVENTIONS: The disrupted orbicularis oris muscle was reoriented and sutured. A simple linear commissuroplasty technique was used, and the cheek skin was closed linearly without Z-plasty. MAIN OUTCOME MEASURES: The distances from Cupid's bow peak to the oral commissure were measured bilaterally, and the difference between the normal and cleft sides was obtained. Finally, its proportional value as a percentage of the total lip length was calculated from short- and long-term follow-up photographs. Cheek scarring and its effects on melolabial fold breakage were evaluated. RESULTS: Of the 18 patients who underwent transverse facial cleft repair, 12 were included in this study. The mean follow-up period based on medical photographs was 1773.5 days. The average proportional difference was 4.6%, demonstrating no observable commissural migration. There were no consistent trends in the direction of migration, either on the cleft or normal side. In patients with a transverse cleft crossing the melolabial fold, the folds appeared broken before and after the cleft repair surgery. CONCLUSIONS: No significant long-term commissural migration was observed after transverse facial cleft repair with simple linear commissuroplasty and linear skin closure. Deliberate positioning of the new oral commissure, proper myoplasty, and meticulous skin closure with minimal scar burden can be considered key procedures for successful transverse cleft repair.
Assuntos
Fenda Labial , Procedimentos de Cirurgia Plástica , Humanos , Lactente , Estudos Retrospectivos , Lábio/cirurgia , Mucosa Bucal/cirurgia , Fenda Labial/cirurgia , Fenda Labial/patologia , Cicatriz/cirurgiaRESUMO
SUMMARY: The buccinator myomucosal flap, also referred to as a buccal myomucosal flap, is an effective technique to address velopharyngeal insufficiency after cleft palate repair. Challenges related to flap harvesting may deter plastic surgeons from incorporating this strategy as a first-line treatment. The primary objective of this study and accompanying video is to provide support regarding indications, planning, and surgical steps of the buccinator myomucosal flap technique, including important technical details for soft-palate dissection and flap harvesting.
Assuntos
Fissura Palatina , Procedimentos de Cirurgia Plástica , Insuficiência Velofaríngea , Humanos , Insuficiência Velofaríngea/etiologia , Insuficiência Velofaríngea/cirurgia , Mucosa Bucal/cirurgia , Retalhos Cirúrgicos/cirurgia , Fissura Palatina/cirurgiaRESUMO
Objetivo: Relatar um caso de hiperplasia fibrosa inflamatória em lábio inferior, decorrente de um transtorno de comportamento repetitivo (mordedura) e o seu devido tratamento. Relato de caso: Paciente do gênero masculino, 27 anos de idade, apresentou aumento de volume em região de lábio inferior, indolor, com evolução clínica de seis a sete meses, com relatos de práticas de mordedura em região de lábio inferior. Ao exame clínico observou-se lesão exofítica em coloração de mucosa, pediculada, medindo cerca de 8mm, no seu maior diâmetro, com aspecto circunferencial, consistente à palpação e não sangrante. O paciente foi submetido à biópsia excisional, mantendo-se uma distância mínima de 5mm do pedículo. Conclusão: No caso relato, o paciente foi submetido a uma biópsia excisional com a completa remoção da lesão e obteve um prognóstico favorável... (AU)
Objective: To report a case of inflammatory fibrous hyperplasia in the lower lip, resulting from a repetitive be havior disorder (biting) and its proper treatment. Case report: Male patient, 27 year sold, presented pain less swelling in the lowerl ipregion, with clinical evolution of sixt o seven months, with report sof biting practices in the lower lip region. Clinical examination revealed an exophytic lesion in mucosal color, peduncula ted, mea suring about 8 mm in its largest diameter, with a circumferent ial appearance, consisten ton palpation and not bleeding. The patient underwent excisional biopsy, keeping a minimum distance of 5 mm from the pedicle. Conclusion: In the case report, the patient underwent a nexcision al biopsy with the complete removal of the lesion and obtained a favorable prognosis... (AU)
Objetivo: Informar de un caso de hiperplasia fibrosa inflamatoria del labio inferior debido a um trastorno de comportamiento repetitivo (morder) y su tratamiento. Reporte de caso: Paciente masculino, de 27 años, presentó un aumento de volumen em la región del labio inferior, indoloro, com evolución clínica de seis a siete meses, con reporte de prácticas de mordedura em la región del labio inferior. El examen clínico reveló una lesión exofítica, pedunculada, de coloración mucosa, que medía aproximadamente 8mm em su mayor diámetro, de aspecto circunferencial, consistente a la palpación y no sangrante. El paciente fue sometido a una biopsia excisional, manteniendo una distancia mínima de 5mm del pedículo. Conclusión: Em el caso relatado, el paciente fue sometido a una biopsia excisional com la remoción completa de lalesión y obtuvo um pronóstico favorable... (AU)
Assuntos
Humanos , Masculino , Adulto , Neoplasias Bucais , Mucosa Bucal/cirurgia , Mucosa Bucal/patologiaRESUMO
This literature review is devoted to the analysis of indications for ureteroplasty with a buccal flap, its technique, and the alternative surgical options. Reconstructive surgery of the ureter has more than a century of history, during which various surgical interventions have been proposed and improved depending on the location and length of the stricture. Over the past decades, a method of replacing the ureter with a flap from the buccal or tongue mucosa was introduced. The use of such flaps for the ureteral reconstruction is not a new concept; the possibility of performing such a procedure was confirmed at the end of the last century. Successful results of experimental and clinical studies have allowed the gradual adoption of this technique to replace long defects in the upper and middle third of the ureter. In buccal ureteroplasty, robot-assisted approach is widely used, contributing to a high success rate and fewer postoperative complications. The accumulation of experience in such reconstructive procedures and the analysis of the results allow to clarify the indications and contraindications, improve the technique, and carry out multicenter studies. According to the literature, ureteroplasty using a buccal or tongue mucosa flap is most suitable for long narrowing of the ureteropelvic junction, the upper and middle third of the ureter, which are amenable to endoscopic procedures or segmental resection with end-to-end anastomosis.
Assuntos
Procedimentos de Cirurgia Plástica , Procedimentos Cirúrgicos Robóticos , Ureter , Obstrução Ureteral , Humanos , Ureter/cirurgia , Retalhos Cirúrgicos , Procedimentos Cirúrgicos Urológicos/métodos , Mucosa Bucal/cirurgia , Obstrução Ureteral/cirurgiaAssuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Humanos , Mucosa Bucal/cirurgia , Mucosa Bucal/patologia , Estudos de Viabilidade , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Ultrassonografia de IntervençãoAssuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Humanos , Mucosa Bucal/cirurgia , Mucosa Bucal/patologia , Estudos de Viabilidade , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Ultrassonografia de IntervençãoRESUMO
OBJECTIVE: The aim: To analyze the results of inflammatory and immunological parameters of the oral cavity after cystectomy with different methods of connecting the edges of the operated area. PATIENTS AND METHODS: Materials and methods: The research was conducted in 87 patients who sought surgical treatment of odontogenic cysts of the jaws. Patients were divided into groups depending on the method of wound closure after surgery. We analyzed the results of laboratory tests (leukocytes, ESR, IL-1ß, IL-6, TNF-α, IL-8, NO synthase, MMP-9). RESULTS: Results: The analysis of the effectiveness of using different methods of approximation of the oral mucosa wound on inflammatory and immunological pa¬rameters showed that when using welding of the edges of the operated area using the EKVZ-300 "Patonmed" apparatus, we get positive results of laboratory indicators of inflammatory markers faster (leukocyte counts are normal on day 30, ESR, IL-1ß - on the 14th day, TNF-α - on the 7th day, IL-6, IL-8, NO synthase, MMP-9 - on the 30th day), that is, healing in such patients is faster than in patients with wound closure with classic suture material or laser. CONCLUSION: Conclusions: When comparing the methods of approximation of postoperative oral mucosa wounds by different methods, based on the results of these inflammatory and immunological parameters, the best results were obtained when using electric welding of tissues. Further research and use of the proposed method will facilitate and shorten the rehabilitation period of patients after surgery.
Assuntos
Metaloproteinase 9 da Matriz , Fator de Necrose Tumoral alfa , Humanos , Interleucina-6 , Cistectomia , Interleucina-8 , Mucosa Bucal/cirurgiaRESUMO
PURPOSE: The purpose of this study is to determine if depth of infiltration is the only risk factor that will determine the outcomes in early-stage buccal mucosa patients or do the other minor risk factors have an impact too. METHODS: It is a retrospective analysis of 226 patients with early-stage buccal mucosa cancer who were treated with curative intent from 2010 to 2020. These patients were grouped in two arms, surgery alone (n = 111) and surgery followed by adjuvant radiotherapy (n = 115). Patients were followed up and local and regional recurrences and distant metastasis were recorded. RESULTS: Our results show that addition of radiation to the standard surgery arm improves overall survival and disease-free survival, though the improvement in overall survival was not statistically significant. This improvement was more pronounced in the depth of infiltration > 5 mm and in 5 mm or less depth of infiltration this benefit was not statistically significant. Other factors like perineural invasion, lymphovascular invasion, tumour size, node positive, margin positive were considered for univariate analysis. Although there was a trend towards improvement of OS and DFS, it was not statistically significant as far as these factors are concerned. CONCLUSION: The role of adjuvant radiation in early-stage cancers of buccal mucosa is a crucial tool with definitive DFS benefit and requires more prospective trials to answer the OS benefit.