Altered anatomy in a case with a buccally impacted maxillary canine tooth.

Bilateral dissections of maxilla were performed in a human adult cadaver head, male, aged 53 years. After the en block removal of the soft tissues in the oral and infraorbital regions, the antero-lateral surface of maxilla was exposed and also the vestibular aspect of the upper alveolar process. An oblique labially impacted right upper canine was evidenced, completely submucosal: its apex was tangent to the maxillary sinus floor, while the superior side of the apical part of the root was in close relation with the floor of the laterally expanded inferior nasal meatus. Superior and adjacent to the neck of that impacted canine a follicular cyst was evidenced and the antral wall presented distally to the apex of the impacted canine a dehiscent area, where the antral mucosa was only covered by an incomplete thin bony lamella. The incisors on that side were present but no resorption was identified at their level. Within the anterior border of the wall separating the maxillary sinus, small, and the inferior nasal meatus, the nerve for that impacted canine was coursing; the nerves for the upper incisors were initially located within the antero-lateral wall of the inferior nasal meatus. Although small, the maxillary sinus presented a supero-medial recess above the enlarged inferior nasal meatus and lateral to the normally-sized middle nasal meatus.

Former and present aspects in upper level of viscero-skull architecture.

The classical reference material describes two resistance arcs, the maxillary arc and the mandibulary arc, from which the masticatory forces direct themselves towards the functional resistance structures of the viscero-skull. From the maxillary arc, three pairs of vertical pillars ascend (that is fronto-nasal, zygomatic and pterygoid). Certain authors add to these a median arc--the bony part of the nasal septum. From the mandibulary arc, the lines of force make for the cordyle and the coronoid process of the mandible. In terms of the new outlook, at the upper level of the viscero-skull, there are five vertical blades described: one median, two medial and two lateral, those last including the pillars from the classical descriptions. These vertical blades are joined by three horizontal laminae: the upper one, the middle one--interrupted by the median line and the lower one--included in the concavity of the maxillary arc. These structures of laminae induce the formation of some resistance cylinders and cones. Within the lower level of the viscero-skull there are three mandibulary arcs described: the upper one (the classic mandibulary arc), the middle one (with an oblique direction) and the lower one.

The heterogeneity of craniofacial morphology in Prader-Willi patients.

Prader-Willi syndrome is a complex genetic disorder with narrow spectrum of facial phenotypic signs, which make the clinical diagnosis difficult in some cases. There are several reports describing the craniofacial appearance of Prader-Willi patients, but there are only a few cephalometric studies for these patients. In this study were included 18 patients with Prader-Willi syndrome and a control group of 18 subjects of both sexes selected based on specific criteria. The cephalometric radiographs of the patients were taken using the standardized technique with centric teeth in occlusion and lips in relaxed position. Angular, horizontal and linear measurements were analyzed for the study group and for the control group. We established that in Prader-Willi patients, there is a decrease of the majority of parameters but the degree of this reduction varies widely between patients and clinically typical facies not always have smaller measurements which can be found in an unusual facies. Facial dysmorphism in Prader-Willi patients varies a group ranging from miss proportions that do not alter the facial architecture as regard of facial typology, skeletal class and pattern of development to a severe disturbance of those. There is a degree of clinical heterogeneity between subjects with Prader-Willi syndrome on clinical evaluation and cephalometric study confirms the heterogeneity for this patients. Because the identification of smaller dimensions for majority of parameters in children and adults, the possibility of developmental delay or growth retardation delay can be excluded. These findings are important for the orthodontist for optimum timing of orthodontic management of patients with Prader-Willi syndrome.

Cephalometric investigation of Class III dentoalveolar malocclusion.

The aim of our study was to identify the most important anatomical landmarks in the cephalometric evaluation of Class III patients and to clarify the morphological characteristics of these cases. A group of 10 Class III orthodontic patients was evaluated in this study. The control group consisted of 10 patients with average occlusion and skeletal characteristics. Digital lateral cephalometric X-rays were performed and different measurements were analyzed. Cephalometric data were evaluated with the CephX specialized software for orthodontic diagnosis and the results were statistically analyzed. The Class III group presented specific characteristics such as prognathic mandible, large gonial angle, short maxillary length, higher lower facial height. These findings can be useful for the diagnosis and treatment planning of orthodontic cases with dental÷keletal anomalies, especially in cases when surgical approach is considered. The surgical decision must be taken after an accurate investigation of the lateral cephalometric parameters.

Helicobacter pylori infection and gastric MALTomas: an up-to-date and therapy highlight.

During the last 20 years Helicobacter pylori (Hp) has been, undoubtly, the star of gastroenterology and microbiology, so much to deserve the "Nobel prize 2005" for biology and medicine to its discoverers. More recently, an increased interest arised on Hp and its linkages with other medical fi elds such as immunology, surgery and dentistry. The outcome of the pathologies due to such bacterium is dependent on many factors, including bacterial genotype, host physiology and genetics, and environmental factors such as diet. In spite of its clear involvement in some pathologies like acute and chronic gastritis, peptic ulcer and gastric cancer, very little is known about another pathology recently proved to be closely associated to the infection by Hp: the gastric MALToma, which account for 7% of all newly diagnosed non-Hodgkin's lymphoma. The chronic infection of the gastric mucosa from Helicobacter pylori primes a complex pathogenic process which could determine the onset of the gastric cancer through some intermediary steps. On these bases, in 1994, the International Agency for Cancer Research (IARC) defined this bacterium a "class I carcinogenic agent" for gastric cancer. The MALT lymphomas are the most frequent lymphoid neoplasms of the digestive tract; we can also observe other and more rare lymphomatous tumours with specific clinical patterns, like the T-lymphoma associated with lymphomatous polyposis and enteropathy. The development of gastric lymphomas is usually preceded by the acquisition of lymphatic tissue, after inflammatory stimuli and particularly after the infection from Hp, which organizes itself with the characteristics of the MALT. Recently, a number of papers have highlighted the remarkable efficacy of Hp eradicating therapy in patients with low-grade MALT lymphoma of the stomach without other modalities, e.g. surgery and systemic chemotherapy. The aim of this study is to be helpful for a comprehensive understanding the possible connections between Hp and gastric MALT lymphoma, evaluating the best therapy strategies, surgical and non surgical, actually available for its treatment.