RESUMO
Adenotonsillar hypertrophy is a common paediatric/otolaryngological disorder that may be associated with secondary growth or facial growth impairment, sleep disturbances, neurocognitive deficits, or smell loss. Surgical removal of the hypertrophic tissue eliminates the mechanical obstacle of the airways and is therefore curative in most cases. The purpose of the present review is to outline the impact of adenotonsillar hypertrophy and adenotonsillectomy on growth, facial growth, sleep, behaviour and smell.
Assuntos
Desenvolvimento Infantil/fisiologia , Inflamação/complicações , Desenvolvimento Maxilofacial/fisiologia , Transtornos Mentais/etiologia , Otorrinolaringopatias/complicações , Olfato/fisiologia , Criança , Doença Crônica , Humanos , Inflamação/fisiopatologia , Transtornos Mentais/fisiopatologia , Otorrinolaringopatias/fisiopatologia , Fatores de RiscoRESUMO
Isolated marginal facial nerve paresis after TMJ discopexy: a case report. This is the first report of a transient, isolated marginal facial nerve paresis after temporomandibular joint arthrotomy. The paresis seems to have resulted from a crush lesion by Backhaus forceps, placed transcutaneously during the operation to distract the intra-articular space.
Assuntos
Anquilose/cirurgia , Traumatismos do Nervo Facial/complicações , Paralisia Facial/etiologia , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Adulto , Anquilose/complicações , Diagnóstico Diferencial , Traumatismos do Nervo Facial/diagnóstico , Traumatismos do Nervo Facial/reabilitação , Paralisia Facial/diagnóstico , Paralisia Facial/reabilitação , Feminino , Seguimentos , Humanos , Modalidades de Fisioterapia , Complicações Pós-Operatórias , Transtornos da Articulação Temporomandibular/complicaçõesRESUMO
OBJECTIVES: To evaluate whether orthodontic loading has an effect on miniplate stability and bone mineral density (BMD) around the screws supporting those miniplates. SETTING AND SAMPLE POPULATION: Two miniplates were inserted in each jaw quadrant of 10 dogs. MATERIAL AND METHODS: Two weeks later, coil springs were placed between the miniplates of one upper quadrant and between those of the contralateral lower quadrant. The other miniplates remained non-loaded. The dogs were sacrificed 7 or 29 weeks after surgery, and the jaws were scanned with peripheral Quantitative Computed Tomography (pQCT) to assess BMD. RESULTS: The success rate was not significantly different for the loaded and the non-loaded miniplates, but was significantly higher for the maxillary compared to the mandibular ones. Mobility, associated with local inflammation, most often occurred during the transition between primary and secondary stability. pQCT showed higher BMD around mandibular vs. maxillary screws, without significant difference between loaded and non-loaded ones. Furthermore, load direction did not lead to any significant difference in BMD. CONCLUSION: Miniplate stability and BMD of the adjacent bone did not appear to depend significantly on orthodontic loading, but rather on the receptor site anatomy.
Assuntos
Densidade Óssea , Placas Ósseas , Análise do Estresse Dentário , Procedimentos de Ancoragem Ortodôntica/instrumentação , Técnicas de Movimentação Dentária , Animais , Parafusos Ósseos , Cães , Estimativa de Kaplan-Meier , Masculino , Miniaturização , Titânio , Tomografia Computadorizada por Raios X/métodosRESUMO
3D printed models are often very similar in shape and can be inadvertently switched if the related patient is not identified correctly. Here, we present a free and simple method to imprint letters and numbers in a 3D model. CT scan data were used to create an STL file of a patient's mandible. We then used Blender software to modify it with numbers and letters. We chose to imprint a series of four letters and numbers on our 3D models. We chose representative letters and numbers of the Latin alphabet. Six models were printed with an Up plus 2 - easy 120 3D printer with different character sizes and shape to evaluate the readability. All models were printed without any failures. Regarding readability, 2 mistakes were made among ten readers. The favourite extrusion depth was 3 mm, and the largest model was preferred. Identification can be done at different times and by different means, but identifying the 3D model during its creation is safer. Moreover these identified 3D models could be saved in the digital patient medical file. The identification location should take into consideration the future indication of the 3D printed medical model. We recommend that 3D identification should be done using at least 7.5mm high, with a depth of 3mm. Our method allows easy, fast and free 3D text. This 3D text identification printing method may be a first step towards the legal use of 3D printed models made within the hospital.
Assuntos
Modelos Anatômicos , Impressão Tridimensional , Humanos , Mandíbula , Software , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The risk of metastasizing in axillary lymph node is occasional in the head and neck cancers. This pattern of spread is difficult to explain and totally unpredictable even for these lymphophilic cancers. OBSERVATION: A 72-year-old patient benefited, 11 years ago, of surgical oncology care associated with adjuvant radiotherapy for squamous cell carcinoma of the left floor of the mouth (pT4 pN2b M0). He presented a second primary malignancy at the right oropharyngeal level. Pet CT revealed a right infraclinic axillary metastasis. The metastatic origin was confirmed by pathological analysis. DISCUSSION: The current management of head and neck cancers is based on the histological pattern of infiltration, the size of the primary tumor and the pattern of metastasizing lymph nodes and potential distant spreading. Current tests allow us to diagnose most distant metastases even outside the usual area of lymphatic drainage. Involvement of axillary lymph node, probably through retrograde lymphatic spreading is not so rare in recurrences of oropharyngeal cancer (T3-T4, N2 ) as we have observed in the literature. In this review, we raise some degree of similarity between such oncological progression and factors related to this aberrant spreading.
Assuntos
Segunda Neoplasia Primária , Neoplasias Orofaríngeas , Idoso , Humanos , Linfonodos , Metástase Linfática , Masculino , Recidiva Local de NeoplasiaRESUMO
OBJECTIVES: The objectives of this animal study were to evaluate if orthodontic loading has an impact on osseointegration of screws supporting miniplates, and to describe the histological components of the bone-screw interface. MATERIALS AND METHODS: Eighty orthodontic miniplates were placed in the jaws of 10 dogs. After 2 weeks, a 125 g force was applied between the miniplates of one upper quadrant of each dog and between those of the controlateral lower quadrant. The others, nonloaded miniplates, were considered as controls. Five dogs were sacrificed 7 weeks after implantation and the remaining five dogs after 29 weeks [Short Term (ST) and Long Term (LT) groups, respectively]. Fluorochromes were injected at implantation and at sacrifice. Jaw quadrants were dissected, embedded, cut into undecalcified transverse sections through the screws and finally submitted to microradiographic analysis to allow assessment of bone-implant contact (BIC) and bone volume/total volume (BV/TV). The sections were observed under UV light and stained in order to examine them under ordinary light. RESULTS: Osseointegration occurred around 90/160 screws and consisted mainly in limited repair and remodelling processes of lamellar bone, without inflammation. Wide variations were observed in BIC and BV/TV, but without any significant difference, neither between the loaded and the nonloaded screws, nor according to the direction of load, whereas they were significantly higher in the LT than in the ST group. Nonosseointegrated screws were surrounded by fibrous tissue. Osteoblastic activity, when present in front of these screws, was not sufficient to achieve stability. CONCLUSIONS: Osseointegration underlying orthodontic anchorage was not affected by loading. BIC increased with time and varied according to implantation site. Particularly the tight-fitting screw insertion appeared crucial in determining the appropriate bone healing response.
Assuntos
Placas Ósseas , Parafusos Ósseos , Mandíbula/cirurgia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Animais , Remodelação Óssea/fisiologia , Corantes , Cães , Falha de Equipamento , Fibrose , Corantes Fluorescentes , Masculino , Mandíbula/patologia , Maxila/patologia , Microrradiografia , Osseointegração/fisiologia , Osteoblastos/patologia , Osteócitos/patologia , Estresse Mecânico , Propriedades de Superfície , Fatores de Tempo , Raios UltravioletaRESUMO
We have examined expression of bone morphogenetic protein 3 (BMP-3) mRNA in normal rat osteoblasts in culture as they undergo differentiation to form bone-like structures, and have found that expression of BMP-3 mRNA in primary fetal rat calvarial (FRC) cells is discontinuous and shows at least four different-sized transcripts. BMP-3 mRNA expression has a distinct temporal pattern during bone cell differentiation of FRC osteoblasts. Previously, we showed that BMP-3 mRNA is expressed in normal and neoplastic rat and human prostate tissues, and in human osteosarcoma cells, as multiple transcripts. To compare the nature of these transcripts in different tissues, three cDNA clones encoding BMP-3 have been isolated by reverse transcription-polymerase chain reaction (RT-PCR) and cDNA library screening from human prostate cancer PC-3 cells, rat prostate adenocarcinoma PA III cells, and primary FRC cells. Analysis of these clones has revealed that the nucleotide sequence of BMP-3 found in human prostate cells is identical to that found in human bone cells. The rat BMP-3 sequences from bone and prostate cells are also identical but show a high degree of variation in the pro- or precursor region compared with human BMP-3. The biological significance of these differences in these two species is unknown.
Assuntos
Proteínas Morfogenéticas Ósseas , Substâncias de Crescimento/genética , Osteoblastos/metabolismo , Neoplasias da Próstata/genética , Proteínas/genética , Adenocarcinoma/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Southern Blotting , Proteína Morfogenética Óssea 3 , Células Cultivadas , DNA Complementar/genética , Expressão Gênica , Substâncias de Crescimento/química , Humanos , Masculino , Dados de Sequência Molecular , Proteínas/química , RNA Mensageiro/genética , Ratos , Homologia de Sequência de Aminoácidos , Células Tumorais CultivadasRESUMO
PURPOSE: The aim of this study was to assess the pharmacokinetics, biodistribution and metabolism of [(18)F]EF3, a labelled 2-nitroimidazole hypoxia marker, in ten patients with head and neck cancer. METHODS: [(18)F]EF3 was administered intravenously (group 1, n=5, mean dose+/-SD: 324+/-108 MBq; group 2, n=5, mean dose+/-SD: 1,134+/-138 MBq) to patients (nine male, one female). Blood and urine samples and whole-body PET scans were obtained from 20 s to 4-6 h. Radioactivity was determined in several regions of interest. RESULTS: No serious adverse event was reported. [(18)F]EF3 concentration in blood exhibited a bi-exponential decline. [(18)F]EF3 was mainly eliminated in the urine. By 7 h 40 min after injection, 53+/-14% of the injected dose was collected in the urine. There was no significant difference between the low- and high-dose groups. A progressive accumulation occurred also in the colon, indicating a hepatobiliary excretion. Except in organs involved in the elimination of [(18)F]EF3, the tumour-to-organ ratio remained close to or below unity in muscle, lungs, heart and brain at various times after injection. In one patient, tumour hypoxia was observed with a tumour-to-blood ratio ranging from 1.4 to 1.9. Last, [(18)F]EF3 remained very stable after injection, with percentage of native tracer above 87% in the serum and 84% in the urine. CONCLUSION: Administration of [(18)F]EF3 in head and neck cancer patients is feasible and safe. Uptake and retention in tumour was observed, indicating the presence of hypoxia.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Hipóxia/diagnóstico por imagem , Nitroimidazóis/farmacocinética , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico por imagem , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Neoplasias Faríngeas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/farmacocinética , Distribuição TecidualRESUMO
INTRODUCTION: Patient's age is known to have no influence on either treatment or prognosis of oral squamous cell carcinoma. OBSERVATION: A 94-year old female patient, with a squamous cell carcinoma of the floor of the mouth, stage pT1pN0cM0, was classically treated by surgical tumor resection, selective neck dissection and immediate surgical reconstruction with a vascularized radial flap. DISCUSSION: This clinical case, which could be a record taking into account the patient's advanced age, confirms that treatment decision of oral squamous cell carcinoma must not be influenced by age. Only some age-related comorbidities must be considered.
Assuntos
Carcinoma de Células Escamosas/patologia , Soalho Bucal/patologia , Neoplasias Bucais/patologia , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Soalho Bucal/cirurgia , Neoplasias Bucais/cirurgia , Esvaziamento Cervical , Estadiamento de Neoplasias , Retalhos CirúrgicosRESUMO
The management of benign and malignant neoplasms of the salivary glands requires precise knowledge of tumor histogenesis and classification as well as surgical skills. Pleomorphic adenoma and Whartin's tumor are the most frequent tumors in parotid glands while the probability for malignant tumors is higher in other glands, especially in sublingual and minor salivary glands. Those malignant salivary glands tumors are rare and necessitate multidisciplinar staging and management in close collaboration with the pathologist and the radiation oncologist.
Assuntos
Neoplasias das Glândulas Salivares/cirurgia , Adenolinfoma/patologia , Adenoma Pleomorfo/patologia , Humanos , Estadiamento de Neoplasias , Prognóstico , Radioterapia Adjuvante , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Neoplasias da Glândula Sublingual/patologiaRESUMO
INTRODUCTION: We present an original three-dimensional cephalometric analysis based on a transformation of a classical two dimensional topological cephalometry. METHODS: To validate the three-dimensional cephalometric CT based concept we systematically compared the alignments of anatomic structures. We used digital lateral radiography to perform the classical two-dimensional cephalometry, and a three-dimensional CT surface model for the three-dimensional cephalometry. RESULTS: Diagnoses based on both two-dimensional and three-dimensional analyses were adequate, but the three-dimensional analysis gave more information such as the possibility of comparing the right and left side of the skull. Also the anatomic structures were not superimposed which improved the visibility of the reference landmarks. CONCLUSION: We demonstrated that three-dimensional analysis gives the same results as two-dimensional analysis using the same skull. We also present possible applications of the method.
Assuntos
Cefalometria/métodos , Imageamento Tridimensional , Crânio/anatomia & histologia , Tomografia Computadorizada por Raios X , Humanos , Reprodutibilidade dos Testes , Crânio/diagnóstico por imagem , SoftwareRESUMO
In the framework of the preclinical validation of the hypoxic tracer [(18)F]EF3, a comparison was performed between uptake of [(18)F]EF3 and EF5 adducts detected by immunofluorescence in MCa-4, FSA, FSAII, Sa-NH and NFSA tumour-bearing mice. Mice were allowed to breath carbogen (5% CO(2), 95% O(2)), 21% oxygen or 10% oxygen. A significant correlation (r (2)=0.57; p<0.01) was found between the [(18)F]EF3 tumour-to-muscle ratio and the fluorescence intensity of EF5.
Assuntos
Etanidazol/análogos & derivados , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/metabolismo , Hidrocarbonetos Fluorados/metabolismo , Neoplasias Mamárias Experimentais/diagnóstico por imagem , Neoplasias Mamárias Experimentais/metabolismo , Nitroimidazóis/farmacocinética , Oxigênio/metabolismo , Animais , Hipóxia Celular , Avaliação Pré-Clínica de Medicamentos , Etanidazol/metabolismo , Imunofluorescência , Masculino , Taxa de Depuração Metabólica , Camundongos , Camundongos Endogâmicos C3H , Especificidade de Órgãos , Cintilografia , Compostos Radiofarmacêuticos/farmacocinética , Distribuição TecidualRESUMO
The object of this research is to investigate the influence of interleukin-1 (IL-1) on heterotopic ossification (HO) induced by bone morphogenetic protein (BMP). Adult mice were implanted with doses of 1, 2, 5, and 10 mg of BMP. Several local injections of 10, 100, and 1000 units of a recombinant IL-1 beta (rIL-1 beta) were administered during the morphogenetic phase of development, starting a day before operation until one week postoperation. While IL-1 acts principally on cell proliferation, BMP primarily shows cell differentiation in the form of HO. BMP-induced HO is quantitated by computer X-ray image scanning, bone ash weight, alkaline phosphatase activity, and histological methods. The area of human BMP-induced HO was completely abolished by injections of polyclonal and monoclonal anti-IL-1 antibody. Monoclonal antibody did not cross-react with the same efficiency as polyclonal with bovine BMP. Polyclonal anti-IL-1 antibody totally neutralizes bovine BMP activity. IL-1-enhanced BMP induced HO and increased the volume of new bone in a statistically significant increment.
Assuntos
Substâncias de Crescimento/farmacologia , Interleucina-1/farmacologia , Osteogênese/efeitos dos fármacos , Proteínas/farmacologia , Fosfatase Alcalina/sangue , Animais , Anticorpos Monoclonais , Proteínas Morfogenéticas Ósseas , Bovinos , Diferenciação Celular/efeitos dos fármacos , Quadril/diagnóstico por imagem , Humanos , Masculino , Camundongos , Radiografia , Proteínas Recombinantes/farmacologiaRESUMO
This article describes extensively and systematically oral mucosa diseases. Macroscopical aspects are particularly described in order to give the dentist all important elements of differential diagnosis. This nosological description is based on a clinical approach: white and pigmented lesions are distinguished from ulcerated and benign so as malignant tumoral lesions. Specifically on the oral mucosa located lesions and oral mucosa lesions of systemic diseases are described.
Assuntos
Doenças da Boca/diagnóstico , Mucosa Bucal/patologia , Cistos/classificação , Cistos/diagnóstico , Cistos/patologia , Doenças do Sistema Endócrino/classificação , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/patologia , Gastroenteropatias/classificação , Gastroenteropatias/diagnóstico , Gastroenteropatias/patologia , Doenças Hematológicas/classificação , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/patologia , Herpes Zoster/diagnóstico , Herpes Zoster/patologia , Histiocitose/classificação , Histiocitose/diagnóstico , Histiocitose/patologia , Humanos , Hipersensibilidade/classificação , Hipersensibilidade/diagnóstico , Hipersensibilidade/patologia , Leucoplasia Oral/diagnóstico , Leucoplasia Oral/patologia , Doenças da Boca/classificação , Doenças da Boca/patologia , Doenças da Boca/virologia , Neoplasias Bucais/classificação , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Úlceras Orais/classificação , Úlceras Orais/diagnóstico , Úlceras Orais/patologia , Transtornos da Pigmentação/classificação , Transtornos da Pigmentação/diagnóstico , Transtornos da Pigmentação/patologia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/patologia , Estomatite Herpética/diagnóstico , Estomatite Herpética/patologia , Doenças da Língua/classificação , Doenças da Língua/diagnóstico , Doenças da Língua/patologiaRESUMO
Tracking down the oral mucosa lesions require precise interrogation and cervico-facial, buccal and general examination. Diagnosis needs more often biopsy if not contra-indicated. The opportunity of further examinations and tests is discussed.
Assuntos
Doenças da Boca/diagnóstico , Mucosa Bucal/patologia , Biópsia , Técnicas de Laboratório Clínico , Contraindicações , Humanos , Anamnese , Doenças da Boca/patologia , Palpação , Exame Físico , Fatores de TempoRESUMO
The early detection and follow up of oral mucosa lesions are a must for every dentist. The importance of these activities is tremendous for oral cancerous and precancerous lesions, so every dentist is officially responsible for this important role in the public health. The modalities of such early detection and follow up are described.
Assuntos
Odontólogos , Doenças da Boca/diagnóstico , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Doença Crônica , Seguimentos , Humanos , Doenças da Boca/prevenção & controle , Neoplasias Bucais/prevenção & controle , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/prevenção & controle , Saúde PúblicaRESUMO
The management of lesions of the oral mucosa requires precise knowledges and expertise in clinical care. This review article summarise the principles of the most validated therapeutical features about lesions of the oral mucosa. Global management procedures are described. Therapeutic modalities involving drugs, surgery, radiotherapy, chemotherapy, immunotherapy, electrotherapy, gene therapy and photodynamic therapy are detailed as well.
Assuntos
Doenças da Boca/terapia , Mucosa Bucal/patologia , Neoplasias Bucais/terapia , Anti-Infecciosos Locais/uso terapêutico , Antineoplásicos/uso terapêutico , Biópsia , Criocirurgia , Terapia Genética , Humanos , Imunoterapia , Doenças da Boca/classificação , Doenças da Boca/diagnóstico , Neoplasias Bucais/classificação , Neoplasias Bucais/diagnóstico , Fotoquimioterapia , Lesões Pré-Cancerosas/classificação , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/terapia , Dosagem RadioterapêuticaRESUMO
This paper reviews the literature about the most relevant complications in daily orthognathic surgery. Although orthognathic surgery has proven to be relatively safe, patients who undergo such maxillofacial orthopaedic surgery must be aware of the side effects of this combined treatment. Immediate life-threatening complications are very rare. They can in most cases be avoided by good anaesthetic and surgical techniques and adequate postoperative care. The most frequently encountered perioperative problem in maxillary surgery is excessive blood loss, whilst subjective neurosensory disturbance is the most frequent complication in mandibular surgery. Good co-operation between orthodontist and surgeon is essential to prevent most immediate and late postoperative problems and nearly all unsatisfactory results.
Assuntos
Anormalidades Craniofaciais/cirurgia , Complicações Intraoperatórias , Má Oclusão/cirurgia , Ortodontia Corretiva/efeitos adversos , Complicações Pós-Operatórias , Perda Sanguínea Cirúrgica , Humanos , Mandíbula/cirurgia , Mastigação , Maxila/cirurgia , Osteonecrose/etiologia , Osteotomia/efeitos adversos , Osteotomia de Le Fort/efeitos adversos , Planejamento de Assistência ao Paciente , Hemorragia Pós-Operatória/etiologia , Recidiva , Transtornos de Sensação/etiologia , Infecção da Ferida Cirúrgica/etiologia , Doenças Dentárias/etiologia , Falha de Tratamento , CicatrizaçãoRESUMO
The management of oral injuries requires expertise in dental and medical cares. The need for a multidisciplinary assessment, including medical, has to be ascertained early. Diagnostic and management procedures are described as well as concomitant lesions such as maxillofacial bony fractures.
Assuntos
Traumatismos Maxilofaciais/complicações , Traumatismos Dentários/complicações , Adulto , Processo Alveolar/lesões , Criança , Fixação de Fratura , Humanos , Fraturas Maxilomandibulares/complicações , Fraturas Maxilomandibulares/terapia , Traumatismos Maxilofaciais/terapia , Equipe de Assistência ao PacienteRESUMO
Encapsulation of DNA in a new non-cationic multilamellar vector (Spherulites), composed of phosphatidylcholine, cholesterol and polyoxyethylene alcohol, is described here for the first time. Spherulites entrapping DNA were prepared by shearing a phospholipid lyotropic lamellar phase, using a recently discovered method. The average diameter of these vesicles ranges around 300 nm, and can be adjusted depending on the conditions of the process. The formulation did not result in cytotoxicity for the human cells and could be used as a DNA delivery system. More emphasis is brought to the role of condensing agents like histones on the encapsulation yield, which has been studied using radiolabelled DNA. It is shown that use of histones (histone to DNA ratio of 0.4) can increase significantly the encapsulation of DNA, thus improving the transfection efficiency. Transfection experiments were done with success using the beta-galactoside reporter gene on human primary cells (human skin fibroblasts and human bone marrow stromal cells). The results suggest that the spherulites have to be considered as a new and promising tool for gene transfection.