Dental and Maxillofacial Manifestations of Axenfeld-Rieger Syndrome: Presentation of a Case in a 5-Year-Old Girl.

In this case study, the dental and maxillofacial manifestations of a 5-year-old girl with Axenfeld-Rieger syndrome (ARS) are described. This syndrome is characterized by craniomaxillofacial, ocular, dental, and umbilical disorders. The patient presented ocular dyscoria and corectopia, iris abnormalities, midface hypoplasia with a thin upper lip, and a protruded lower lip. Hyperplastic maxillary labial frenulum, oligodontia, ghost teeth, bilateral Class III molar and canine relationship, and right posterior crossbite were also found. An everted umbilicus with redundant periumbilical skin was evident. Early diagnosis of ARS is essential to establishing preventive and corrective measures that provide a good quality of life for patients who suffer from this syndrome.

Mandibular Body Reconstruction Utilizing a Three-Dimensional Custom-Made Porous Titanium Plate: A Four-Year Follow-Up Clinical Report.

A clinical case of a 42-year-old woman patient, who had a mandibular reconstruction utilizing a three-dimensional (3D) custom-made porous titanium plate dental restoration, is presented. She showed a recurrence of a unicystic ameloblastoma involving the left hemimandible. The patient declined to be managed by a bone-free flap. A mandibular resection in the healthy areas was provided, followed by reconstruction utilizing a 3D custom-made porous titanium plate dental restoration with a hybrid dental prosthesis. The 3D rehabilitation was created considering slim tomodensitometric sections. The cutting guides and custom-created 3D plate were fabricated employing medical software via computer-aided design and fabricating with locations planned for healing abutments. The patient was contented with the rehabilitation, and the condition continued stable at the four-year follow-up.

A Case Report of a Lingual Cyst Lined by Respiratory Epithelium in a Child.

The lingual cyst lined by respiratory epithelium is a rare pathology. It probably appears from the default of undifferentiated cells of the foregut during embryonic growth. This pathology is seen more often in males and children; however, only 5 patients younger than 4 years old have been reported. The pathophysiology and the management of this cyst were described in a 4-year-old girl. She presented with a soft mass on the dorsum of the tongue covered by normal mucosa, which existed since her birth, causing difficulty in eating, breathing, and talking. The magnetic resonance described a hyperintense image with an anteroposterior diameter of 27 mm, craniocaudal of 19 mm, and transversal of 26 mm in the midline groove of the tongue; the scintigraphy showed normality. The enucleation of the lesion was performed, eradicating the capsule of the cyst and obtaining a complete cleavage. The histopathologic examination defined a cyst lined predominantly by respiratory epithelium. Unlike in other cases, in this case their cystic lining and capsular constituents were contemplated considering the current histological recommendations. It is relevant to differentiate this pathology from other cysts with similar histological findings.

Maxillofacial management of dog bites injuries in an infant: A case report / Manejo maxillofacial por mordeduras de perro en un infante: Reporte de un caso / Manejo maxilofacial de mordidas de cães em criança: Relato de caso

Abstract Dog bites cause complex craniomaxillofacial injuries. Considering that the bite injuries are repeatedly situated on the face, dentist requires being well known with the therapy of animal bites. A three-year-old male child was attended as a victim of a Pit Bull terrier biting. The patient had multiple wounds at the level of the upper eyelid of the right eyeball, left hemisphere with the involvement of the auricular pavilion, wounds with multiple detachments on face and scalp, several abrasions and ecchymoses in the bilateral infraorbital and mouth region. The clinical intervention was completed in the first twenty-four hours after injury. The affected zones were cleaned and irrigated with saline solution, and the wounds were sutured in layers. Tetanus and anti-rabies vaccination, and antibiotic and analgesic were administered. On the fifth postoperative day, the stitches were removed, and the patient was discharged from the hospital. One week after the trauma, the child showed adequate wound curing absent of aggravation. Satisfactory aesthetic and functional results were achieved. Besides, in this case, the most relevant aspects of the management of dogs bites are presented.

Resumen Las mordeduras de perros causan lesiones craneomaxilofaciales complejas. Teniendo en cuenta que las lesiones por mordedura están situadas repetidamente en la cara, el odontólogo debe conocer la terapia que se debe realizar en el caso de mordeduras de animales. Un niño de tres años fue atendido como víctima de una mordedura de Pit Bull terrier. El paciente tenía múltiples heridas a nivel del párpado superior del globo ocular derecho, hemisferio izquierdo con afectación del pabellón auricular, heridas con múltiples desprendimientos en la cara y el cuero cabelludo, varias abrasiones y equimosis en la región bilateral infraorbitaria y bucal. La intervención clínica se completó en las primeras veinticuatro horas después de la lesión. Las zonas afectadas se limpiaron e irrigaron con solución salina, y las heridas se suturaron en capas. Se administraron vacuna antitetánica y antirrábica, antibióticos y analgésicos. En el quinto día postoperatorio, se retiraron los puntos de sutura y el paciente fue dado de alta del hospital. Una semana después del trauma, el niño mostró curación adecuada de la herida sin agravación. Se lograron resultados estéticos y funcionales satisfactorios. Además, en este caso, se presentan los aspectos más relevantes del manejo de las mordeduras de perros.

Resumo Mordidas de cães causam lesões craniomaxilofaciais complexas. Considerando que as lesões por mordidas são repetidamente situadas na face, um cirurgião oral e maxilofacial exige ser bem conhecido com a terapia de mordidas de animais. Um menino de três anos foi vítima de uma picada de um terrier de Pit Bull. O paciente apresentava múltiplas feridas no nível da pálpebra superior do globo ocular direito, hemisfério esquerdo com envolvimento do pavilhão auricular, feridas com múltiplos descolamentos na face e couro cabeludo, várias abrasões e equimoses na região infraorbital e boca bilateral. A intervenção clínica foi concluída nas primeiras vinte e quatro horas após a lesão. As zonas afetadas foram limpas e irrigadas com solução salina e as feridas foram suturadas em camadas. Vacinação antitetânica e anti-rábica e antibióticos e analgésicos foram administrados. No quinto dia de pós-operatório, os pontos foram retirados e a paciente recebeu alta do hospital. Uma semana após o trauma, a criança apresentou cura adequada da ferida, sem agravamento. Resultados estéticos e funcionais satisfatórios foram alcançados. Além disso, neste caso, são apresentados os aspectos mais relevantes no manejo das mordidas de cães.

Diagnosis and treatment for central Mucoepidermoid Carcinoma in the mandible: Report of a clinical case in a young patient.

A clinical case of a 13 year old male patient with a malignant tumor in the mandibular body area with two years of evolution and associated pain is reported. It was initially diagnosed as low grade central mucoepidermoid carcinoma through Hematoxylin and Eosin (H-E) staining in multiple biopsies. Considering the clinical and radiographic characteristics of the lesion, it was necessary to confirm the diagnosis through Periodic acid-Schiff (PAS). The treatment involved hemimandibulectomy, neck emptying, and complementary radiotherapy. This article aims to present a rare occurrence of this type of intraosseous malignant tumor of glandular origin in a young patient. Key words:Mucoepidermoid carcinoma, periodic acid Schiff reaction, pathology, surgery, radiotherapy.

Aneurysmal bone cyst of the mandible with conservative surgical management: A case report.

The aneurysmal bone cyst is a nonneoplastic, osteolytic and locally destructive lesion that mainly affects the metaphyseal area of long bones and only 2% of it is diagnosed in the maxillofacial skeleton. Although surgical treatment is the most common option, it is associated to high morbidity rates. The case of an aneurysmal bone cyst of a considerable size in a 27-year-old male patient illustrating a conservative surgical approach with preservation of the dental structures in the mandible to limit aesthetic and functional side effects is presented. Two-year clinical follow-up was performed with no evidence of recurrence. Key words:Aneurysmal bone cyst; curettage, conservative treatment, mandibular osteotomy.

Immunoexpression of p53 in Oral Squamous Cell Carcinoma and Oral Dysplastic Lesions in Patients with the Habit of Reverse Smoke / Inmunoexpresión de p53 en Carcinoma Bucal Escamo Celular y Displasias Orales en pacientes con el Hábito de Fumar Invertido

Molecular biological markers have been suggested to be of value in the diagnosis and prognostic evaluation of precancerous lesions. The purpose of the current study was to investigate the expression of p53 protein in normal oral mucosa, oral dysplastic lesions (DL), and oral squamous cell carcinoma (SCC), comparing patients with the habit of reverse smoking and conventional smokers. The patients were subjected to incisional biopsy and the soft tissue specimens were routinely fixed in 10% formalin and processed in the laboratory. Immunohistochemical technique was performed using the avidin-biotin-peroxidase protocol. The 102 patients included 42 reverse smokers and 60 conventional smokers. There were 79 cases of mild, 15 of moderate, and 3 of severe epithelial dysplasia. Five microinvasive oral SCC included one male and four females. The clinical characteristics of microinvasive tumors included patches, plaques or erosions; 100% showed positive nuclear staining for p53. It was found a significant association of p53 expression and exposure of reverse smoking among microinvasive oral SCC and oral DL patients in the population studied.

Marcadores biológicos moleculares se han sugerido para ser de valor en el diagnóstico y evaluación pronóstica de lesiones precancerosas. El propósito del presente estudio fue investigar la expresión de la proteína p53 en mucosa oral normal, lesiones displásicas orales (LD), y en el carcinoma oral de células escamosas (COCC), comparando pacientes con el hábito de fumar convencional y fumar invertido. Los pacientes fueron sometidos a biopsia por incisión y los especímenes de tejidos blandos fueron fijados en formalina al 10% y se procesaron en el laboratorio. La técnica inmunohistoquímica se realizó utilizando el protocolo de avidina-biotina-peroxidasa. De los 102 pacientes incluidos, 42 fueron fumadores invertidos y 60 fumadores convencionales. Hubo 79 casos de displasia epitelial leve, 15 moderada, y 3 severa. Cinco casos de COCC microinvasivo incluyeron un hombre y cuatro mujeres. Las características clínicas de los tumores microinvasores incluyen parches, placas o erosiones; el 100% mostró tinción nuclear positiva para p53. Se encontró una asociación significativa de la expresión de p53 y la exposición de los fumadores invertidos entre pacientes con COCC microinvasivo y DL en la población estudiada.

Adenoma pleomórfico benigno del paladar: presentación de un caso / Benign pleomorphic adenoma of the palate: a case presentation

Fundamento: el tumor más común de las glándulas salivales es el adenoma pleomórfico. Es un tumor mixto que se presenta con frecuencia en la glándula parótida. Objetivo: presentar las características clínicas e histopatológicas de un adenoma pleomórfico localizado en el paladar. Se describe también el tratamiento realizado. Caso clínico: se presenta el caso de una paciente con un adenoma pleomórfico localizado en el paladar duro. El tumor de 7 cm por 5 cm se encontraba cubierto de mucosa normal firme, en algunos sitios con poca resiliencia, gomosa, no dolorosa; además los dientes de la zona presentaron movilidad. De acuerdo con la radiografía se observó una zona esclerótica difusa y desde el punto de vista histopatológico se detectó la presencia de nidos, cordones y estructuras ductales, con una secreción luminal eosinofílica. A la paciente se le realizó una maxilectomía parcial y colocación de férula intraquirúrgica. Conclusiones: aunque el adenoma pleomórfico es un tumor benigno requiere un tratamiento quirúrgico con resección de un margen de tejido sano debido a que tiende a infiltrar la cápsula. En el presente caso su dimensión fue tal que requirió una maxilectomía parcial.

Background: benign pleomorphic adenoma is the most common tumor in the salivary glands. It is a mixed tumor that frequently appears in the parotid gland. Objective: to present the clinical and histopathologic characteristics of a benign pleomorphic adenoma located in the palate. Clinical case: the case of a patient with a pleomorphic adenoma in the hard palate is presented. The tumor, that was 7 cm by 5 cm, was covered with a normal firm mucosa which had not much resilience and was rubbery and non-painful. Besides, the teeth in the area presented mobility. According to the radiography, there was a diffuse sclerotic region and from the histopathologic point of view, nests, cords, and ductal structures were detected, along with a luminal eosinophilic secretion. The patient underwent a partial maxillectomy and the placing of an intrasurgical splint. Conclusions: in spite of the fact that the pleomorphic adenoma is a benign tumor, it requires a surgical treatment with removal of a part of healthy tissue because the adenoma tens to infiltrate the capsule. The present case, due to its dimensions, required a partial maxillectomy.

Revisión sistemática de los efectos del hábito de fumar invertido sobre la mucosa oral / Systematic revision of the effects of the reversed smoking habit on the oral mucosa

Fundamento: se ha postulado que el hábito de fumar invertido intensifica la severidad de las enfermedades de la mucosa bucal y expone a las personas a riesgos severos en la salud oral. Objetivo: revisar la literatura científica acerca de las enfermedades de la mucosa oral asociadas con el hábito de fumar invertido. Método: se realizó una revisión sistemática de investigaciones observacionales y experimentales publicadas en las bases de datos Medline-Pubmed y SCIELO desde 1960 hasta 2012. Se utilizaron términos en diferentes combinaciones: nicotinic stomatitis, reverse smoking, reverse smokers, oral cancer, oral premalignant lesions y tobacco. Se excluyeron las series de casos, resultados duplicados debido a las combinaciones de los términos de búsqueda, datos no disponibles, cartas al editor y revisiones históricas. Desarrollo: se detectó en todos los estudios revisados que el hábito de fumar invertido es más frecuente en mujeres que en hombres. Doce investigaciones mostraron asociación entre el hábito de fumar invertido y carcinoma del paladar duro o tumores microinvasivos. Se observó que los fumadores invertidos tienen muchas más probabilidades de presentar parches y áreas rojas en el paladar, además de leucoplasias y carcinomas. El riesgo estimado de presentar carcinoma del paladar duro fue 132 veces mayor en mujeres con el hábito de fumar invertido. Las tasas de mortalidad ajustadas por edad fueron casi dos veces más altas para los fumadores invertidos en comparación con aquellas personas que no fumaban. Conclusiones: el hábito de fumar invertido está asociado con el cáncer oral y con otras enfermedades avanzadas de la mucosa bucal. Se deben realizar estudios de intervención para tratar de persuadir a las poblaciones acerca del abandono de los hábitos de tabaquismo.

Background: It is been said that the reversed smoking habit intensifies the seriousness of the diseases of the buccal mucosa and put people at serious risks regarding oral health. Objective: to revise the scientific literature related to the diseases of the oral mucosa associated to reversed smoking habit. Method: a systematic revision of observational and experimental investigations published in the Medline-PubMed and SciELO data bases from 1960 to 2012 was made. Terms were used in different combinations: nicotinic stomatitis, reverse smoking, reverse smokers, oral cancer, oral premalignant lesions y tobacco. Series of cases, duplicated results due to combinations of search terms, non-available data, letters to the editor and historical revisions were excluded. Results: in all the revised studies it was revealed that reversed smoking habit is more frequent in women than in men. Twelve investigations showed association between reversed smoking habit and carcinoma of the hard palate or microinvasive tumors. It was observed that inverted smokers are at more risk of presenting blotches and red areas in the palate, as well as leukoplakias and carcinomas. The estimated risk of presenting carcinoma of the hard palate was 132 times higher in women that have the reverse smoking habit. Mortality rates set by age were almost twice higher for reverse smokers compared to non-smokers. Conclusions: reversed smoking habit is associated to oral cancer and to other advanced diseases of the buccal mucosa. Intervention studies should be conducted in order to try to persuade populations to quit smoking.

Lesiones bucales potencialmente malignas / Potentially malignant oral lesions

Existen muchas lesiones que pueden afectar no solo la lengua sino también el resto de la mucosa de la cavidad oral. Además de la descripción de las entidades más comunes, se presentan fotos ilustrativas. Pretendemos mostrar varias lesiones, que eventualmente pueden tornarse en una verdadera enfermedad maligna; de igual modo, se describen signos de alerta para sospechar cuándo una lesión de la cavidad oral se ha transformado en carcinoma…

There are many lesions that can affect not only the tongue but also the entire oral cavity mucosa. Along with a description of the most common entities, an illustrative picture is shown. We intend to show a wide number of lesions that eventually might become a true malignant disease; giving at the same time, hints as to when to suspect that one of these oral cavity lesions has turned into a carcinoma…

Características clínicas e histopatológicas del carcinoma escamocelular bucal en el periodo 1990-2004 en Medellín, Colombia / Clinical and histopathological features of oral squamocellular carcinoma during 1990-2004 in Medellin, Colombia

El carcinoma escamocelular bucal es una neoplasia maligna frecuente en la cavidad bucal, sin embargo, no existe información sobre la incidencia y el comportamiento clínico e histológico de este tipo de cáncer en Antioquia, Colombia. Este estudio proveyó información acerca de las características clínicas e histopatológicas del carcinoma escamocelular bucal, proveniente de historias clínicas de 197 pacientes, con un total de 112 hombres (56,9 por ciento) y 85 mujeres (43,1 por ciento), atendidos en el Hospital Universitario San Vicente de Paúl, en Medellín, Colombia, durante un periodo de 14 años. La localización más frecuente del carcinoma escamocelular bucal fue la lengua (45,0 por ciento), seguido del paladar duro (17,1 por ciento), luego le siguió el paladar blando con el 9,0 por ciento y por último el piso de la boca con el 8,5 por ciento. La mayoría de estos carcinomas fueron diagnosticados en estadios tardíos III y IV (74,9 por ciento). En cuanto al grado de diferenciación predominaron los carcinomas bien y moderadamente diferenciados(AU)

The oral scamocellular carcinoma is a frequent malignant neoplasia located in the oral cavity; however, there is not information on the incidence and clinical behavior of this type of cancer in Antioquia, Colombia. Present study provides information on the clinical and histopathological features of the oral scamocellular carcinoma collected from the medical records of 197 persons, 112 men (56.9 percent) and 85 females (43.1 percent) seen in the "San Vicente de Paúl" University Hospital of Medellin for 14 years. The more frequent location of the oral scamocellular carcinoma was the tongue (45.0 percent), followed by the hard palate (17.1 percent), soft palate 9.0 percent and mouth floor (45 percent); most of these ones were diagnosed in late stages (III and IV) (74,9 percent), as regards the differentiation degree there was predominance of well and moderately differentiated carcinomas(AU)

Características clínico-histopatológicas del carcinoma escamocelular bucal, Colombia / Clinical-histopathology features of oral squamous cell carcinoma in Medellin, Colombia

El carcinoma escamocelular bucal (CEB), es una neoplasia maligna frecuente en cavidad oral. Objetivo: determinar la incidencia y el comportamiento clínico e histológico de este tipo de cáncer en Antioquia, Colombia. Métodos: éste estudio provee información acerca de las características clínicas e histopatológicas del CEB, proveniente de historias clínicas de 197 personas 112 (56,9 por ciento) hombres y 85 (43,1 por ciento) mujeres atendidas en el hospital Universitario San Vicente de Paúl de Medellín, durante un periodo de 14 años. Resultados: 197 historias fueron estudiadas, el 61,9 por ciento (122) de la población, era mayor de 60 años al momento del diagnóstico, 78,7 por ciento (157) fueron procedentes de Antioquia, el 78,6 por ciento (155), tenían antecedente tabaquismo, el 17,8 por ciento (35) de las personas, reportaron en la historia antecedentes familiares de cáncer. La localización más frecuente del CEB, fue la lengua 45 por ciento (90), seguido de paladar duro 17,1 por ciento (34), paladar blando 9 por ciento (17) y piso de boca 8,5 por ciento (17); la mayoría de estos (74,9 por ciento), fueron diagnosticados en estadios tardíos (III y IV), en cuanto al grado de diferenciación predominaron los carcinomas bien y moderadamente diferenciado, 45,2 por ciento (89) y 42,6 por ciento (84) respectivamente(AU)

Buccal squamous cell carcinoma (SCC) is frequent malign neoplasm in oral cavity; however, there isn't information on its incidence and clinical and histological behavior of this type of cancer in Antioquia (Colombia). Methods: Present study supply information on the clinical and histological features of SCC from medical records of 197 persons (56.9 percent) (112 of male sex and 85 of female sex (43.1 percent) seen in "San Vicente de Paúl" University Hospital of Medellin for 13 years. Results: A total of 197 medical records were studied, the 61.9 percent (122) of population aged over 60 at diagnosis, 78.7 percent (157) from Antioquia, and the 78.6 percent (155) had smoking backgrounds, and the 17.8 percent (35) of persons had a family history of cancer. More frequent location of SCC was in tongue for a 45 percent (90), followed by hard palate for a 17.1 percent (17) and mouth floor for a 8.5 percent (17), most of them (7.9 percent) were diagnosed with late stages (III and IV) regards the differentiation degree the carcinoma were well and moderately differentiated, 45.2 percent (89) and 42.6 percent (84), respectively(AU)

Reverse smokers's and changes in oral mucosa. Department of Sucre, Colombia.

OBJECTIVES: This work is intended to establish the prevalence of reverse smokers at the villages of Hato Nuevo, San Francisco and Cayo de Palma, Department of Sucre, Colombia, characterizing their socio-culture conditions, clinical and histological changes in the oral mucosa. DESIGN OF STUDY: A descriptive study was done through a home to home inquiry to select the people with inclusion criteria for a posterior clinical test and a biopsy of the affected oral mucosa. RESULTS AND CONCLUSIONS: Reverse smokers's prevalence was from the 15%, mainly women (p<0.001) with an age average of 59.3 years. The lesions were classified clinically in mild, moderate and severe changes. Tongue moderate lesions presented the higher frequency (80%), followed by severe lesions on palate (74%). Oral cancer prevalence was 10.8% in the San Francisco village and 18.2% in Cayo de Palma village, no new cases were reported in Hato Nuevo village. This was the highest prevalence reported in comparison with other studies with similar population. The clinical and histological findings agree with the reported in literature, no relation was found between the degree of clinical severity and the dysplasia itself. Cases of oral submucous fibrosis-like lesions were found, which had never been reported in Latin America. Further studies are required in order to decrease the morbidity for this habit and to identify other related risk factors.

Reverse smokers’s and changes in oral mucosa. Department of Sucre, Colombia

No disponible

Objectives: This work is intended to establish the prevalence of reverse smokers at the villages of Hato Nuevo, San Francisco and Cayo de Palma, Department of Sucre, Colombia, characterizing their socio-culture conditions, clinical and histological changes in the oral mucosa.Design of study: A descriptive study was done through a home to home inquiry to select the people with inclusion criteria for a posterior clinical test and a biopsy of the affected oral mucosa.Results and conclusions: Reverse smokers’s prevalence was from the 15%, mainly women (p<0.001) with an ageaverage of 59.3 years. The lesions were classified clinically in mild, moderate and severe changes. Tongue moderate lesions presented the higher frequency (80%), followed by severe lesions on palate (74%). Oral cancer prevalence was 10.8% in the San Francisco village and 18.2% in Cayo de Palma village, no new cases were reported in Hato Nuevo village. This was the highest prevalence reported in comparison with other studies with similar population. The clinical and histological findings agree with the reported in literature, no relation was found between the degree of clinical severity and the dysplasia itself. Cases of oral submucous fibrosis-like lesions were found, which had never been reported in Latin America. Further studies are required in order to decrease the morbidity for this habit and to identify other related risk factors (AU)

Adenoma pleomórfico en glándulas salivales menores: reporte de tres casos en niños / Pleomorphic adenoma in minor salivary gland: report of three cases in children

Los tumores de las glándulas salivares son escasos durante la primera y segunda décadas de la vida y cuando ocurre en estos grupos de edades, se presentan generalmente en la glándula parótida. Los tumores en las glándulas salivares menores son todavía más escasos, siendo el adenoma pleomórfico el más común. La mayoría de los autores definen el adenoma pleomórfico como una tumoración submucosa oval o redondeada, única, bien delimitada, no infiltante, dura-elástica e indolora. La mucosa que lo cubre está intacta, sin embargo, puede ulcerarse secundariamente debido al crecimiento intrínseco del tumor o por trauma, su crecimiento es lento. Cuando el adenoma pleomórfico se presenta en el paladar se debe hacer diagnóstico diferencial con otras patologías como son las de tipo infeccioso, los quistes y los tumores odontogénicos y no odontogénicos y finalmente, las lesiones pseudotumorales. El tratamiento para el adenoma pleomórfico es la enucleación completa; la mayoría de los autores recomiendan la excisión local amplia extendiéndose al menos medio cm. por fuera del márgen visible del tumor. Puede ser necesaria la fenestración del paladar blando para obtener los márgenes quirúrgicos requeridos. En la literatura mundial solo se han reportado 8 casos de adenoma pleomórfico en el paladar en niños. Presentamos 3 casos de adenomas pleomórficos en glándulas salivares menores del paladar en pacientes de sexo masculino: uno en un niño de 8 años y dos casos en jóvenes de 15 años de edad.