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1.
BMC Oral Health ; 24(1): 1037, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39232693

RESUMEN

BACKGROUND: Palatal groove represents a relatively uncommon developmental root anomaly, usually found on the palatal aspect of maxillary incisors. While its origin is controversial, its presence predisposes to severe periodontal defects. AIM: This study aimed to provide a systematic review of the literature focusing on the varied diagnostic techniques and treatment modalities for periodontal lesions arising from the presence of palatal groove. Based on the existing evidence and knowledge, the study also provides a comprehensive decisional tree, guiding clinicians in the challenging decision-making process face to a palatal groove. METHODS: The literature search was conducted on Medline and Cochrane databases by two independent reviewers, who also performed the screening and selection process, looking for English written articles reporting on diagnosis and management (all treatment approaches) of periodontal lesion(s) associated with a palatal groove. Based on this literature, a comprehensive decisional tree, including a standardized palatal groove evaluation and tailored treatment approaches, is proposed. Moreover, a clinical case is described to demonstrate the practical application of the developed decisional tree. RESULTS: Over a total of 451 articles initially identified, 34 were selected, describing 40 patients with 40 periodontal lesions associated with palatal grooves. The case report illustrates a deep, large, circumferential intra-bony defect on the palatal side of the tooth #22 associated with a shallow, moderately long palatal groove in an 18-year-old male patient. Following reevaluation, a single flap surgery was deemed necessary, combined with a regenerative procedure. At 2 years post-treatment, the tooth #22 is healthy, in a functional and esthetic position. The decision-making process, based on local and systemic patient's conditions, should allow an early and precise diagnosis to prevent further complications and undertake an adequate treatment. CONCLUSION: Palatal grooves are relatively rare; however, they are frequently associated with severe periodontal defects. The identification, diagnosis, prompt, and tailored management of the associated lesion is essential to mitigate potential periodontal and endodontic complications related to the presence of palatal groove. SYSTEMATIC REVIEW REGISTRATION: [ https://www.crd.york.ac.uk/prospero/ ], identifier [C CRD42022363194].


Asunto(s)
Árboles de Decisión , Enfermedades Periodontales , Humanos , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/terapia , Raíz del Diente/anomalías , Raíz del Diente/diagnóstico por imagen , Incisivo/anomalías , Hueso Paladar/patología , Hueso Paladar/anomalías
2.
Br Dent J ; 237(6): 465-471, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39333814

RESUMEN

Cocaine usage is increasing at a rate faster than population growth worldwide. The habitual and chronic insufflation of pulverised cocaine is associated with the progressive destruction of the osseocartilaginous structures of the midface, termed cocaine-induced midline destructive lesions (CIMDLs). These entities present a challenging diagnostic picture, mimicking other infectious, malignant and inflammatory conditions associated with midface destruction. CIMDLs can present along a wide spectrum of disease, with minimal palatal perforation to extensive sinonasal destruction. With the increasing usage of cocaine, there is likely to be a concurrent increase in patients presenting to emergency departments with these destructive entities. Therefore, there is a need to create awareness of this uncommon entity and to document a systematic approach that must be adopted to reach a definitive diagnosis which will subsequently inform management. We report four clinical cases of CIMDLs at varying stages of the disease process which presented to the Dublin Dental University Hospital between January 2023 and June 2024 and document their multidisciplinary management from initial presentation to eventual treatment.


Asunto(s)
Trastornos Relacionados con Cocaína , Hueso Paladar , Humanos , Masculino , Hueso Paladar/patología , Adulto , Trastornos Relacionados con Cocaína/complicaciones , Femenino , Persona de Mediana Edad , Cocaína/efectos adversos , Diagnóstico Diferencial
3.
Stem Cells Dev ; 33(19-20): 562-573, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39119818

RESUMEN

Although enhanced fibroblast growth factor (FGF) signaling has been demonstrated to be crucial in many cases of syndromic cleft palate caused by tongue malposition in humans, animal models that recapitulate this phenotype are limited, and the precise mechanisms remain elusive. Mutations in FGF9 with the effect of either loss- or gain-of-function effects have been identified to be associated with cleft palate in humans. Here, we generated a mouse model with a transgenic Fgf9 allele specifically activated in cranial neural crest cells, aiming to elucidate the gain-of-function effects of Fgf9 in palatogenesis. We observed cleft palate with 100% penetrance in mutant mice. Further analysis demonstrated that no inherent defects in the morphogenic competence of palatal shelves could be found, but a passively lifted tongue prevented the elevation of palatal shelves, leading to the cleft palate. This tongue malposition was induced by posterior spatial confinement that was exerted by temporomandibular joint (TMJ) dysplasia characterized by a reduction in Sox9+ progenitors within the condyle and a structural decrease in the posterior dimension of the lower jaw. Our findings highlight the critical role of excessive FGF signaling in disrupting spatial coordination during palate development and suggest a potential association between palatal shelf elevation and early TMJ development.


Asunto(s)
Fisura del Paladar , Factor 9 de Crecimiento de Fibroblastos , Cresta Neural , Transducción de Señal , Animales , Cresta Neural/metabolismo , Cresta Neural/patología , Fisura del Paladar/genética , Fisura del Paladar/patología , Fisura del Paladar/metabolismo , Ratones , Factor 9 de Crecimiento de Fibroblastos/metabolismo , Factor 9 de Crecimiento de Fibroblastos/genética , Ratones Transgénicos , Factor de Transcripción SOX9/metabolismo , Factor de Transcripción SOX9/genética , Hueso Paladar/metabolismo , Hueso Paladar/embriología , Hueso Paladar/patología , Articulación Temporomandibular/patología , Articulación Temporomandibular/metabolismo , Lengua/patología , Lengua/metabolismo , Modelos Animales de Enfermedad
4.
Head Face Med ; 20(1): 40, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39090693

RESUMEN

BACKGROUND: Since many different conclusions of craniofacial anomalies and their relation to the posterior airway space coexist, this comparative clinical study investigated the palatal morphology concerning volumetric size, posterior airway space dimension and the adenoids of patients with and without a cleft before orthodontic treatment. METHODS: Three-dimensional intraoral scans and cephalometric radiographs of n = 38 patients were used for data acquisition. The patients were divided into three groups: unilateral cleft lip and palate (n = 15, 4 female, 11 male; mean age 8.57 ± 1.79 years), bilateral cleft lip and palate (n = 8, 0 female, 8 male; mean age 8.46 ± 1.37 years) and non-cleft control (n = 15, 7 female, 8 male; mean age 9.03 ± 1.02 years). The evaluation included established procedures for measurements of the palatal morphology and posterior airway space. Statistics included Shapiro-Wilk-Test and simple ANOVA (Bonferroni) for the three-dimensional intraoral scans and cephalometric radiographs. The level of significance was set at p < 0.05. RESULTS: The palatal volume and cephalometric analysis showed differences between the three groups. The palatal volume, the superior posterior face height and the depth of the bony nasopharynx of patients with cleft lip and palate were significantly smaller than for non-cleft control patients. The superior posterior face height of bilateral cleft lip and palate patients was significantly smaller than in unilateral cleft lip and palate patients (BCLP: 35.50 ± 2.08 mm; UCLP: 36.04 ± 2.95 mm; p < 0.001). The percentage of the adenoids in relation to the entire nasopharynx and the angle NL/SN were significantly bigger in patients with cleft lip and palate than in the non-cleft control. In particular, the palatal volume was 32.43% smaller in patients with unilateral cleft lip and palate and 48.69% smaller in patients with bilateral cleft lip and palate compared to the non-cleft control. CONCLUSIONS: Skeletal anomalies relate to the dimension of the posterior airway space. There were differences among the subjects with cleft lip and palate and these without a cleft. This study showed that the morphology of the palate and especially transverse deficiency of the maxilla resulting in smaller palatal volume relates to the posterior airway space. Even the adenoids seem to be affected, especially for cleft lip and palate patients.


Asunto(s)
Cefalometría , Labio Leporino , Fisura del Paladar , Imagenología Tridimensional , Humanos , Fisura del Paladar/diagnóstico por imagen , Fisura del Paladar/patología , Femenino , Masculino , Labio Leporino/diagnóstico por imagen , Labio Leporino/patología , Niño , Cefalometría/métodos , Ortodoncia Correctiva/métodos , Hueso Paladar/diagnóstico por imagen , Hueso Paladar/patología , Estudios Retrospectivos
5.
BMC Oral Health ; 24(1): 862, 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39075386

RESUMEN

BACKGROUND: The purpose of this study was to assess the effects of systemically given krill oil (KO) on the development of new bone formation in the sutura palatina media following rapid maxillary expansion (RME). METHODS: 28 4-5 week-old male Wistar albino rats were randomly divided into 4 groups: Control (C), Only Expansion (OE) (no supplement but undergoing expansion and retention), KE (supplemented during both the expansion and retention phases), Krill Oil Nursery Group (KN) (supplemented during the 40-day nursery phase as well as during the expansion and retention phases). A 5-day RME was followed by a 12-day retention period. All rats were euthanized simultaneously. Micro-computerized tomography (Micro-CT), hemotoxylen-eosin (H&E) staining, and immunohistochemical analysis were conducted. Kruskal-Wallis and Dunn tests with Bonferonni corrrection were applied (p < 0.05). RESULTS: Expansion and KO supplementation did not cause a statistically significant change in bone mineral density (BMD), bone volume fraction (BV/TV), spesific bone surface (BS/BV) and trabecular thickness (Tb.Th). While the expansion prosedure increased the trabecular seperation (Tb.Sp), KO supplemantation mitigated this effect. The KE group exhibited a statistically significantly increase in trabecular number (Tb.N) compared to the OE group. Although receptor activator of nuclear factor-kappa-Β ligand (RANKL)/osteoprotegerin (OPG) ratios did not show significant differences between groups, the KE and OE groups demonstrated the lowest and highest value, respectively. KE showed a reduced amount of tartrate-resistant acid phosphatase (TRAP) compared to the OE. CONCLUSION: KO positively affected the architecture of the new bone formed in the mid-palatal suture. In this rat model of RME, results support the idea that administering of KO during the expansion period or beginning before the RME procedure may reduce relapse and enhance bone formation within the mid-palatal suture.


Asunto(s)
Euphausiacea , Osteogénesis , Técnica de Expansión Palatina , Ratas Wistar , Microtomografía por Rayos X , Animales , Microtomografía por Rayos X/métodos , Masculino , Ratas , Osteogénesis/efectos de los fármacos , Densidad Ósea/efectos de los fármacos , Inmunohistoquímica , Aceites/farmacología , Distribución Aleatoria , Hueso Paladar/diagnóstico por imagen , Hueso Paladar/patología , Suturas Craneales/efectos de los fármacos , Suturas Craneales/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Maxilar/efectos de los fármacos
6.
Quintessence Int ; 55(6): 494-502, 2024 06 28.
Artículo en Inglés | MEDLINE | ID: mdl-38726762

RESUMEN

OBJECTIVE: The aim of this report was to review oral follicular lymphoid hyperplasia, with emphasis on palatal lesions. METHOD AND MATERIALS: A comprehensive search was performed on PubMed for case reports and case series of palatal follicular lymphoid hyperplasia published in the English language literature. Relevant data from collated articles was sought, including patient demographics, clinical manifestations, imaging modalities and findings, comorbidities, etiopathogenesis, lesional management, and lesional outcome. A new palatal case has also been provided to illustrate several features of this lesion. RESULTS: In total, 32 cases were assembled to establish clinicopathologic correlations, representing the largest aggregation of published cases. Most of the affected patients were at least 60 years old and with a decisive female predilection. The majority of lesions were ≤ 3 cm, appearing as normal color, purple-red or red, and varied from soft to firm. Notably, 32% of palatal follicular lymphoid hyperplasias were associated with denture wear, and lesional recurrence was recorded in 16% of cases. To date, none of the reported cases of palatal follicular lymphoid hyperplasia has undergone malignant transformation. CONCLUSIONS: Palatal follicular lymphoid hyperplasias often arise as a reactive process. Critical histopathologic and histochemical assessments are necessary to establish benignity. Postoperatively, clinicians should follow patients for at least 5 years for recurrence and remain vigilant for neoplastic change as several published accounts of non-oral follicular lymphoid hyperplasias have undergone malignant transformation, usually to lymphoma.


Asunto(s)
Hiperplasia , Humanos , Hiperplasia/patología , Femenino , Seudolinfoma/patología , Seudolinfoma/diagnóstico por imagen , Hueso Paladar/patología , Hueso Paladar/diagnóstico por imagen , Diagnóstico Diferencial , Persona de Mediana Edad
7.
Int J Mol Sci ; 25(8)2024 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-38674123

RESUMEN

Cleft palate only (CPO) is one of the most common craniofacial birth defects. Environmental factors can induce cleft palate by affecting epigenetic modifications such as DNA methylation, histone acetylation, and non-coding RNA. However, there are few reports focusing on the RNA modifications. In this study, all-trans retinoic acid (atRA) was used to simulate environmental factors to induce a C57BL/6J fetal mouse cleft palate model. Techniques such as dot blotting and immunofluorescence were used to find the changes in m6A modification when cleft palate occurs. RNA-seq and KEGG analysis were used to screen for significantly differentially expressed pathways downstream. Primary mouse embryonic palate mesenchymal (MEPM) cells were successfully isolated and used for in vitro experimental verification. We found that an increased m6A methylation level was correlated with suppressed cell proliferation in the palatine process mesenchyme of cleft palate mice. This change is due to the abnormally high expression of m6A methyltransferase METTL14. When using siRNAs and the m6A methyltransferase complex inhibitor SAH to interfere with the expression or function of METTL14, the teratogenic effect of atRA on primary cells was partially alleviated. In conclusion, METTL14 regulates palatal mesenchymal cell proliferation and cycle-related protein expression relies on m6A methylation modification, affecting the occurrence of cleft palate.


Asunto(s)
Proliferación Celular , Fisura del Paladar , Células Madre Mesenquimatosas , Metiltransferasas , Hueso Paladar , Tretinoina , Animales , Fisura del Paladar/genética , Fisura del Paladar/metabolismo , Fisura del Paladar/patología , Tretinoina/farmacología , Ratones , Metiltransferasas/metabolismo , Metiltransferasas/genética , Proliferación Celular/efectos de los fármacos , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/efectos de los fármacos , Hueso Paladar/embriología , Hueso Paladar/metabolismo , Hueso Paladar/patología , Hueso Paladar/efectos de los fármacos , Ratones Endogámicos C57BL , Femenino , Regulación hacia Arriba/efectos de los fármacos , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Adenosina/análogos & derivados , Adenosina/metabolismo
8.
Int Dent J ; 74(5): 1120-1128, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38582717

RESUMEN

OBJECTIVE: To investigate changes in the upper maxillary palates of children with obstructive sleep apnoea (OSA) and mandibular retraction who were treated using modified twin-block appliances (MTBAs). METHODS: Thirty-five OSA children (age: 6-12 years) with mandibular retraction were included as the experimental group and 35 children who were Angle's class I but without mandibular retraction were included as the control group. The experimental group was treated with MTBA. Plaster models were made before the treatment and at the end of the 6-month treatment period. Plaster models of the control group were made at inclusion and after 6 months. Some plaster models were excluded because of damage or their failure to exhibit sufficiently clear marks, which left 26 pairs each for the experimental and control groups. The gender and age of the experimental group were matched with those of the control group at the end of the treatment. Three-dimensional (3D) digital model information was gathered using the external oral scanning model, and the data were extracted and analysed statistically to clarify the morphologic improvement in the maxillopalatine in OSA children treated using MTBAs. RESULTS: After the OSA children with mandibular retraction were treated with MTBAs, the maxillary intercusp width, intermolar width, anterior palate width, posterior palate width, and surface area and volume of the maxillary palate significantly increased (*P < .05). By contrast, the anterior palatal height-apex level (H3) significantly decreased (*P < .05). CONCLUSIONS: Compared with the control group, the narrow maxillary arch and basal bone were significantly enlarged after the OSA children with mandibular retraction were treated using MTBAs. The palatal surface area and volume increased, thereby allowing more space for accommodating the tongue and relieving transverse dissonance of the dentition.


Asunto(s)
Apnea Obstructiva del Sueño , Humanos , Apnea Obstructiva del Sueño/terapia , Niño , Masculino , Femenino , Maxilar , Diseño de Aparato Ortodóncico , Imagenología Tridimensional/métodos , Mandíbula , Hueso Paladar/patología , Cefalometría , Paladar Duro , Estudios de Casos y Controles , Modelos Dentales
10.
Acta Cir Bras ; 39: e390824, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38422328

RESUMEN

PURPOSE: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. METHODS: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. RESULTS: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. CONCLUSIONS: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.


Asunto(s)
Adenoma Pleomórfico , Humanos , Adenoma Pleomórfico/cirugía , Adenoma Pleomórfico/diagnóstico , Adenoma Pleomórfico/patología , Hueso Paladar/patología
11.
JAMA Dermatol ; 159(11): 1272-1273, 2023 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-37819672

RESUMEN

A woman in her 30s had asymptomatic erythematous scaly plaques over the face and proximal extremities. The lesions started as a erythematous papule on the face, which had progressed to larger plaques within 10 years. What is your diagnosis?


Asunto(s)
Hueso Paladar , Anomalías Cutáneas , Femenino , Humanos , Persona de Mediana Edad , Hueso Paladar/patología , Cara/patología
12.
Diagn Cytopathol ; 51(7): E224-E227, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37052154

RESUMEN

Sialadenoma papilliferum, a benign and rare salivary gland neoplasm, accounts for 0.4%-1.2% of all salivary gland tumors and occurs primarily in minor salivary glands of the oral cavity. Here, we report a case of sialadenoma papilliferum and its associated cytological findings. A papillary tumor was incidentally detected on the palate of an 86-year-old Japanese man. Conventional oral exfoliative cytology was performed; the cytology smear exhibited epithelial clusters composed of atypical epithelial cells with a high nuclear/cytoplasm ratio and arranged in sheet or small papillary-like projections. Cytoplasmic vacuoles were also observed in the papillae. It was difficult to make a definitive diagnosis due to the presence of uncommon cytological features. The excisional biopsy specimen revealed histological features characteristic of sialadenoma papilliferum. Mutational analysis detected BRAFV600E mutation, which confirmed the diagnosis of sialadenoma papilliferum. To the best of our knowledge, no prior cytomorphological evaluations of sialadenoma papilliferum have been reported in detail. Oral exfoliative cytology specimens from salivary gland tumors can demonstrate uncommon cytomorphological features. A differential diagnosis of sialadenoma papilliferum can be based on the observation of mildly atypical epithelial cells that form small papillary-like structures.


Asunto(s)
Neoplasias Glandulares y Epiteliales , Neoplasias de las Glándulas Salivales , Masculino , Humanos , Anciano de 80 o más Años , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/patología , Neoplasias Glandulares y Epiteliales/patología , Hueso Paladar/patología , Diagnóstico Diferencial , Glándulas Salivales Menores/patología
13.
Am J Dermatopathol ; 45(5): 326-329, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-36939130

RESUMEN

ABSTRACT: Lymphomatoid papulosis (LyP) belongs to the spectrum of primary cutaneous CD30 + lymphoproliferative disorders, characterized by chronic, recurrent, self-healing papules, small nodules, or ulcers. The clinicopathological features of LyP can mimic overt lymphomas. To date, about 27 intraoral LyP cases have been reported. Of them, only 2 cases were diagnosed as angioinvasive LyP (type E). Herein, we report a 24-year-old Brazilian man who presented a large ulcerated lesion on the hard palate with rapid evolution. Remarkably, there was no involvement of the skin or other mucous membranes. Microscopy revealed a lymphoid infiltrate constituted by medium-sized to large atypical cells, with angiocentric and angiodestructive features. The atypical cells showed immunopositivity for CD3, CD8, CD30, CD56, granzyme B, perforin, and focally for MUM1/IRF4. Ki-67 highlighted almost all atypical lymphoid cells, whereas EBER1/2 was negative. After 2 months of follow-up, the lesion healed completely. Although rare, LyP type E should be included in the differential diagnosis of oral ulcers.


Asunto(s)
Papulosis Linfomatoide , Neoplasias Cutáneas , Masculino , Humanos , Adulto Joven , Adulto , Papulosis Linfomatoide/patología , Neoplasias Cutáneas/patología , Piel/patología , Diagnóstico Diferencial , Hueso Paladar/patología
14.
Gen Dent ; 71(2): 28-31, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36825970

RESUMEN

Mucoepidermoid carcinoma (MEC) is the most common salivary gland adenocarcinoma, more frequently affecting female patients in the fifth decade of life. When MEC arises in the minor salivary glands, the palate is the primary site. This case report describes an MEC on the palate of a 30-year-old woman. The lesion was initially treated as a pyogenic granuloma, but the final diagnosis based on histopathology was low-grade MEC. The patient was referred for cancer treatment, and no recurrence was observed during 3 years of follow-up. Some malignant tumors can mimic nonneoplastic reactive lesions clinically, which highlights the importance of biopsy and proper microscopic analysis of the resulting specimens.


Asunto(s)
Carcinoma Mucoepidermoide , Granuloma Piogénico , Neoplasias de las Glándulas Salivales , Humanos , Femenino , Adulto , Carcinoma Mucoepidermoide/diagnóstico , Granuloma Piogénico/patología , Hueso Paladar/patología , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales Menores/patología
15.
BMC Oral Health ; 23(1): 68, 2023 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-36732751

RESUMEN

BACKGROUND: The present study aimed to evaluate the changes in palate dimension and morphology after treatment of functional posterior crossbite (FPXB) with elastodontic devices (EAs). METHODS: The treatment group (TG) consisted of 25 subjects (mean age 7.3 ± 0.9 years) who received treatment with EA for one year. The control group (CG) comprised 14 untreated subjects (mean age 6.8 ± 0.7 years). INCLUSION CRITERIA: intra-oral scan registered before (T0) and after treatment (T1), FPXB with a mandibular shift towards the crossbite site of ≥ 2 mm, class I molar relationship. EXCLUSION CRITERIA: missing teeth, anterior crossbite, temporomandibular disorders, previous orthodontic treatment, carious lesions, mobility of deciduous posterior teeth, craniofacial deformities. Digital models were analyzed to assess the inter-canine (ICW) and inter-molar widths (IMW) and the corresponding emi-lateral measurements (eICW and eIMW) using the median palatine plane as reference. According to a specific 3D imaging technology, the morphology and symmetry of the palate was investigated by analysing the 3D deviation between the two specular models of the palate. RESULTS: At T0, both groups showed a significantly narrower dimension of eICW and eIMW at the crossbite side compared to the non-crossbite side (p < 0.05). Also, the 3D deviation analysis demonstrates a limited matching percentage of the original/mirrored models in both TG (81.12%) and CG (79.36%), confirming the asymmetry of the palate. The area of mis-matching was located at the alveolar bone level. At T1, subjects in the TG showed a significant increment of ICW and IMW (p < 0.05), a reduction of the differences of eICW and eIMW between both sides (p < 0.05) and an increment of the percentage matching (TG = 92.32%) (p < 0.05), suggesting a significant recovery of the palatal asymmetry. No significant changes were found between T0 and T1 in the CG (p > 0.05). CONCLUSIONS: EAs could be successfully used to correct FPXB in mixed dentition and could restore the harmonious development of the palate in children.


Asunto(s)
Imagenología Tridimensional , Maloclusión , Técnica de Expansión Palatina , Humanos , Imagenología Tridimensional/métodos , Maloclusión/diagnóstico por imagen , Maloclusión/terapia , Maloclusión/patología , Hueso Paladar/patología
16.
Med Oral Patol Oral Cir Bucal ; 28(2): e131-e139, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36806021

RESUMEN

BACKGROUND: The ecoepidemiological panorama of paracoccidioidomycosis (PCM) is dynamic and still ongoing in Brazil. In particular, data about the oral lesions of PCM are barely explored. The aim of this study was to report the clinicopathological features of individuals diagnosed with oral PCM lesions at an oral and maxillofacial pathology service in Rio de Janeiro, Brazil, in the light of a literature review. MATERIAL AND METHODS: A retrospective study was conducted on oral biopsies obtained from 1958 to 2021. Additionally, electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information, and Brazilian Library of Dentistry to gather information from large case series of oral PCM. RESULTS: Ninety-five cases of oral PCM were surveyed. The manifestations were more frequent among males (n=86/90.5%), middle-aged/older adults (n=54/58.7%), and white individuals (n=40/51.9%). The most commonly affected sites were the gingiva/alveolar ridge (n=40/23.4%) and lip/labial commissure (n=33/19.3%); however, one (n=40/42.1%) or multiple sites (n=55/57.9%) could also be affected. In 90 (94.7%) patients, "mulberry-like" ulcerations/moriform appearance were observed. Data from 21 studies (1,333 cases), mostly Brazilian (90.5%), revealed that men (92.4%; male/female: 11.8:1) and individuals in the fifth and sixth decades of life were the most affected (range: 7-89 years), with the gingiva/alveolar ridge, palate, and lips/labial commissure being the sites most frequently affected. CONCLUSIONS: The features of oral PCM lesions are similar to those reported in previous studies from Latin America. Clinicians should be aware of the oral manifestations of PCM, with emphasis on the clinicodemographic aspects and differential diagnoses, especially considering the phenomenon of the emergence of reported cases in rural and/or urban areas of Brazil.


Asunto(s)
Paracoccidioidomicosis , Persona de Mediana Edad , Humanos , Masculino , Femenino , Anciano , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/patología , Estudios Retrospectivos , Brasil , Encía , Hueso Paladar/patología
17.
Anticancer Res ; 43(2): 939-942, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36697075

RESUMEN

BACKGROUND: The clear-cell variant of mucoepidermoid carcinoma (MEC) involving minor salivary glands is extremely rare in children. CASE REPORT: We report a case of clear-cell variant MEC in the minor salivary gland in a 10-year-old boy who presented with a mass of the right hard palate. Fine-needle aspiration showed features suggestive of clear-cell variant of MEC. Microscopically, the tumor cells showed predominant clear cells and scattered mucous cells. There was increased mitotic activity (6/mm2). No tumor necrosis or nuclear pleomorphism was identified. The tumor cells were positive for cytokeratin 7 (CK7), tumor protein p63, P40 (ΔNp63), CK5/6 and mucicarmine. Rearrangement of mastermind-like transcriptional coactivator 2 (MAML2) (11q21) gene was present in the tumor cells by fluorescence in situ hybridization, supporting the diagnosis of an intermediate-grade clear-cell variant of MEC. A right infrastructure maxillectomy for palate carcinoma with negative margins was performed. Grossly, the tumor was a 2.1 cm well-circumscribed, friable, pale tan mass with focal areas of cystic change. The final pathological diagnosis was clear-cell variant of MEC, intermediate grade, pT2. Post surgery, the patient recovered and was doing well, with no tumor recurrence or metastasis at the 6-month follow-up. CONCLUSION: To the best of our knowledge, this is the first documented case of clear-cell variant MEC in a child. Due to low to intermediate tumor grade, an overtly aggressive treatment should be avoided in a child.


Asunto(s)
Carcinoma Mucoepidermoide , Neoplasias de las Glándulas Salivales , Masculino , Niño , Humanos , Proteínas de Unión al ADN/genética , Transactivadores/genética , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/cirugía , Hibridación Fluorescente in Situ , Recurrencia Local de Neoplasia , Factores de Transcripción/genética , Hueso Paladar/patología , Neoplasias de las Glándulas Salivales/genética , Neoplasias de las Glándulas Salivales/cirugía , Neoplasias de las Glándulas Salivales/química
18.
Cleft Palate Craniofac J ; 60(1): 105-109, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-34730025

RESUMEN

Isolated unilateral palatal hypoplasia is an extremely rare congenital disorder that usually causes velopharyngeal incompetence. We herein report a case with isolated unilateral palatal hypoplasia that was treated and followed up over nine years. No hypernasality or articulation errors were observed through the postoperative period. Here the intraoperative and postoperative findings are described.


Asunto(s)
Hueso Paladar , Humanos , Estudios de Seguimiento , Hueso Paladar/patología
19.
Cleft Palate Craniofac J ; 60(6): 701-705, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-35225019

RESUMEN

OBJECTIVE: To examine the safety and efficacy of hyperdry amniotic membrane (HDAM) for wound closure after palatoplasty in cleft palate patients. METHODS: HDAMs were prepared by washing and drying under infrared rays and microwaves at temperatures less than 60°C using a hyperdrying device. A total of 16 cleft palate patients (8 males, 8 females), aged 1 to 3 years (mean age 1 year 9 months), received one-stage pushback palatoplasty. The remaining raw wound after surgery was covered by an HDAM and a plastic cover plate. The cover plate was removed 1 week after surgery and parameters including temperature, feeding, allergic reactions, postoperative bleeding, re-epithelialization, wound dehiscence, and infection were monitored during the follow-up period of 31.2 months. RESULTS: All patients could adequately ingest at 5 days postoperation and after removal of the cover plate. None of the patients had a persistent fever or allergic reactions. Ingestion was feasible immediately in all patients, and no postoperative bleeding was observed during ingestion. No secondary hemorrhages were observed during follow-up. No postoperative wound dehiscence on the midline of the palate was observed. No infections were observed after the removal of the cover plate. No patients suffered from severe scar formation or contracture of the wound in the follow-up period. Hemorrhage, undue epithelialization, and scar contracture did not occur in any patient. The mean evaluation score was 7.75 points. CONCLUSION: HDAM can be used safely and effectively for wound closure following palatoplasty in cleft palate infants. Future studies testing the safety of patient's own amnion for palatoplasty, are required.


Asunto(s)
Fisura del Paladar , Contractura , Masculino , Lactante , Femenino , Humanos , Fisura del Paladar/cirugía , Fisura del Paladar/patología , Amnios , Cicatriz , Hueso Paladar/patología , Contractura/patología , Resultado del Tratamiento , Estudios Retrospectivos
20.
Wound Repair Regen ; 31(2): 156-170, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36571451

RESUMEN

Most human tissue injuries lead to the formation of a fibrous scar and result in the loss of functional tissue. One adult tissue that exhibits a more regenerative response to injury with minimal scarring is the oral mucosa. We generated a microarray gene expression dataset to examine the response to injury in human palate and skin excisional biopsies spanning the first 7 days after wounding. Differential expression analyses were performed in each tissue to identify genes overexpressed or underexpressed over time when compared to baseline unwounded tissue gene expression levels. To attribute biological processes of interest to these gene expression changes, gene set enrichment analysis was used to identify core gene sets that are enriched over the time-course of the wound healing process with respect to unwounded tissue. This analysis identified gene sets uniquely enriched in either palate or skin wounds and gene sets that are enriched in both tissues in at least one time point after injury. Finally, a cell type enrichment analysis was performed to better understand the cell type distribution in these tissues and how it changes over the time course of wound healing. This work provides a source of human wound gene expression data that includes two tissue types with distinct regenerative and scarring phenotypes.


Asunto(s)
Cicatriz , Cicatrización de Heridas , Adulto , Humanos , Cicatrización de Heridas/fisiología , Cicatriz/patología , Piel/patología , Hueso Paladar/patología
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