Osteonecrosis de los maxilares asociada a medicamentos: revisión de la literatura y propuesta para la prevención y manejo / Osteonecrosis of the jaws

Medication-related osteonecrosis of the jaw is a disease where there is necrotic bone exposed or that can be explored by means of a fistula in the maxillofacial region. It has been associated with the use Biphosphonates and denosumab for osteoporosis. Although its etiology is unclear, it may be related to a decrease in bone turnover produced by these drugs, rendering the bone more prone to generate cell necrosis during invasive dental procedures, especially in the posterior region of the jaw. There is no consensus about the prevention and treatment of this condition. The aim of this paper is to present a review of the literature with the main characteristics of osteonecrosis of the jaws associated with drugs, together with a proposal for prevention and treatment for these patients.

[Osteonecrosis of the jaws]. / Osteonecrosis de los maxilares asociada a medicamentos: revisión de la literatura y propuesta para la prevención y manejo.

Medication-related osteonecrosis of the jaw is a disease where there is necrotic bone exposed or that can be explored by means of a fistula in the maxillofacial region. It has been associated with the use Biphosphonates and denosumab for osteoporosis. Although its etiology is unclear, it may be related to a decrease in bone turnover produced by these drugs, rendering the bone more prone to generate cell necrosis during invasive dental procedures, especially in the posterior region of the jaw. There is no consensus about the prevention and treatment of this condition. The aim of this paper is to present a review of the literature with the main characteristics of osteonecrosis of the jaws associated with drugs, together with a proposal for prevention and treatment for these patients.

Adhesivos de cianoacrilato en cirugía oral y maxilofacial / Cyanoacrylate adhesives in oral and maxillofacial surgery

RESUMEN: Los adhesivos de cianoacrilatos (ACA) son materiales sintéticos con propiedades adhesivas. Al ser aplicados en los tejidos polimerizan uniéndose con el tejido subyacente. Desde la década de los 70' se han explorado sus aplicaciones quirúrgicas para el cierre de heridas y fístulas, control de sangrado y fijación de injertos, entre otros, siendo su uso como alternativa para el cierre de heridas en piel y mucosas uno de los más estudiados. Los ACA presentan un limitado grado de absorción, sin evidencia de efectos tóxicos sistémicos. Tienen la ventaja de ser aplicados de forma rápida, indolora, con efecto antibacteriano y hemostático según los reportes de la literatura, pero presentan una reducida fuerza de tensión. El objetivo de esta revisión de la literatura es describir los usos y aplicaciones de los ACA, con enfoque en la cirugía oral y maxilofacial, evaluando de forma crítica sus aplicaciones.

ABSTRACT: The cyanoacrylate adhesives (ACA) are synthetic materials with adhesive properties. When is applied in tissues, it polymerizes and bonds with the underlying tissue. Since the 70s' have been explored their surgical applications for closing wounds, fistulas, bleeding control, and graft fixation, among others. Its use as an alternative for closing wounds in skin and mucous is one of the most studied. The ACA have a limited absorption degree, with no evidence of systemic toxic effects. They have the advantage of being applied quickly, painlessly, with antibacterial effect and hemostatic according to the report of literature, but with reduced tensile strength. The objective of this literature review is to describe the use and applications of ACA, with focus on oral and maxillofacial surgery, with a critically evaluation of their applications.

Desmoplastic Fibroma of the Mandible in a Pediatric Patient: A Case Report of Resection and Reconstruction With A Six-Year Follow-Up.

Desmoplastic fibroma (DF) of bone is considered a benign but locally aggressive tumor of fibroblastic origin. DF is rare, representing less than 1% of all bone tumors. Approximately 84% of patients are younger than 30 years. DF has a slow but aggressive growth potential and can recur locally when it has not been completely excised. Complete resection is the treatment of choice to decrease recurrence and morbidity. Mandibular reconstruction is mandatory in pediatric patients to ensure correct craniofacial development. The present report describes the case of a pediatric patient with mandibular DF in whom complete resection and immediate reconstruction with a fibula flap proved a satisfactory treatment option, with low morbidity and excellent esthetic and functional results at 6-year follow-up.

Spontaneous remission of eosinophilic granuloma of the maxilla after incisional biopsy: a case report.

BACKGROUND: Langerhans cell histiocytosis (LCH), previously known as Histiocytosis X, is an infrequent disease that congregates a wide spectrum of clinical presentations with variable systemic involvement. Unification of these diseases under only one category is based on the almost identical histopathologic features of the lesions, but the etiology and proper approach for each presentation remains controversial. The localized alternative of Langerhans cell histiocytosis (LLCH), known as Eosinophilic Granuloma (EG) of bone, is the predominant clinical presentation of LCH. The maxilla is involved in 1 % of the head and neck region cases, representing an uncommon condition in this area. CASE PRESENTATION: In this clinical case report, it is described a case of a 16-year-old male patient with an asymptomatic osteolytic lesion at first upper left molar apical level, a finding detected on control radiographic images was reported as "Monostotic Eosinophilic granuloma of the maxillary bone", which was later confirmed through an incisional biopsy. A surgical excision was initially planned, but finally it was not performed due to a spontaneous healing of the lesion after the incisional biopsy. CONCLUSIONS: The presented case supports a conservative approach in the management of solitary EG of maxillary and mandibular bone lesions and even supports an expectant attitude in the course of treatment given the possibility of a spontaneous regression after the biopsy, especially in small lesions.