Mandibular Fracture as First Sign of an Occult Intraosseous Hemangioma.

Intraosseous hemangioma (IH) in the maxillofacial area is a very uncommon neoplasm. Here, the authors show an exceptional case not previously reported in the literature of a 65-year-old man who presented with a pathological mandibular fracture following a facial trauma that was the first sign of an occult cavernous IH. Complete excision of the tumor in the mandibular ramus reduced the risk of severe bleeding and prevented long-term recurrence, whereas immobilization of the fracture obtained an excellent functional result. This clinical report highlights the possibility that a previously unknown primary IH may debut as a pathological fracture and the importance of differential diagnosis in this location.

¿Cuál es su diagnóstico? / What would your diagnosis be?

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Disostosis cleidocraneal / Cleidocranial dysostosis

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Conservative management of dentigerous cysts in children.

PURPOSE AND INTRODUCTION: Dentigerous cysts are epithelial in origin and are the most commonly found cyst in children. The majority of these lesions are usually a radiological finding and are capable of quite large before being diagnosed. The standard treatment for these cysts is the enucleation and the extraction of the affected tooth. However, if the patient is a child and the affected tooth is not developed, a more conservative attitude should be considered. MATERIAL AND METHODS: (Clinical case): A 7-year-old patient is presented with an eruptive backlog of the lower permanent first molars. Radiological examination reveals two radiolucid lesions in relation to them, which are compatible with a dentigerous cyst, and in relation to the inferior aveolar nerve and various germs. A partial enucleation is carried out, maintaining all the dental germs related to the cyst in mouth and monitoring the patient until the case study is over. RESULTS AND DISCUSSION: Diagnosis and early treatment of these lesions in children is of great importance, especially in cases where the lesions enclose permanent teeth. CONCLUSIONS: Whenever possible, a conservative attitude should be taken, one that allows for the maintenance of the dentition and treatment of the associated cyst in order to not compromise either the occlusion or the mental state of these patients. KEY WORDS: Dentigerous cyst, conservative treatment, dental impaction, child.

Facial transplantation: A concise update

Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients (AU)

Facial transplantation: a concise update.

OBJECTIVES: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. STUDY DESIGN: MEDLINE search of articles published on "face transplantation" until March 2012. RESULTS: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 9 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. CONCLUSIONS: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients.

Cri du chat syndrome: A critical review

A new syndrome was identified in 1963, when Lejeune et al. reported a genetic disease resulting from a partial ortotal deletion on the short arm of chromosome 5 (5p-) and named it the cri du chat syndrome (CdCS). This termmakes reference to the main clinical feature of the syndrome, a high-pitched monochromatic cat-like crying, thatusually disappears in the first years of life.CdCS is one of the most common chromosomal deletion syndromes in humans, with an incidence of 1:15.000-1:50.000live-births.Our purpose was to review different aspects of this syndrome (concept, epidemiology, aetiology, clinical features,diagnostic methods and prognosis) emphasizing both: the breakthrough in this field introduced by new cytogeneticand molecular techniques, and the orofacial manifestations most frequently reported.The main orofacial anomalies registered were mandibular microretrognathia, high palate but rarely cleft, variablemalocclusion (frequently anterior open-bite), enamel hypoplasia, poor oral hygiene, generalized chronic periodontitis,and retardation of tooth eruption, although there is not enough evidence to support any clear associationbetween these pathologies and the CdCS (AU)

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Cri du chat syndrome: a critical review.

A new syndrome was identified in 1963, when Lejeune et al. reported a genetic disease resulting from a partial or total deletion on the short arm of chromosome 5 (5p-) and named it the cri du chat syndrome (CdCS). This term makes reference to the main clinical feature of the syndrome, a high-pitched monochromatic cat-like crying, that usually disappears in the first years of life. CdCS is one of the most common chromosomal deletion syndromes in humans, with an incidence of 1:15.000-1:50.000 live-births. Our purpose was to review different aspects of this syndrome (concept, epidemiology, aetiology, clinical features, diagnostic methods and prognosis) emphasizing both: the breakthrough in this field introduced by new cytogenetic and molecular techniques, and the orofacial manifestations most frequently reported. The main orofacial anomalies registered were mandibular microretrognathia, high palate but rarely cleft, variable malocclusion (frequently anterior open-bite), enamel hypoplasia, poor oral hygiene, generalized chronic periodontitis, and retardation of tooth eruption, although there is not enough evidence to support any clear association between these pathologies and the CdCS.

Assessment of quality of life in oral cancer.

Quality of life (QL) in oral cancer patients has become one of the most important parameters to consider in the diagnosis and post-treatment follow-up. The purpose of this article has been to review the papers published that study the QL in oral cancer patients, the different QL questionnaires used, the clinical results obtained, and the systematic revisions available in the indexed literature for the last 10 years. The term QL appears as a keyword in an increasing number of articles throughout the past 10 years; however, few studies focus on oral cancer. Most of them assess all head and neck cancers, which conform to a heterogeneous group with several different features depending on location (oral cavity, oropharynx, larynx, hypopharynx, nasopharynx and salivary glands). Most studies evaluate QL in short periods of time, normally within the first year after the diagnosis. Series do not discern between different therapeutic options, and they generally center on Northern European or Northern American populations. There are few instruments translated and validated into Spanish that measure QL, a fundamental characteristic to link QL to own patients' socio-cultural parameters. Data related with QL are mostly related to patient (age, sex, co-morbidity), tumour (location, size), and treatment (surgical treatment, radiotherapy association, reconstruction, cervical dissection, and/or feeding tube). Nowadays QL's assessment is considered an essential component of an oral cancer patient as well as the survival, morbidity and years free of disease. Although many aspects related to QL in oral cancer patients have been published throughout the past 10 years, more systematic research is needed to be able to apply it on a daily basis.

Assessment of quality of life in oral cancer

Quality of life (QL) in oral cancer patients has become one of the most important parameters to consider in thediagnosis and post-treatment follow-up. The purpose of this article has been to review the papers published that studythe QL in oral cancer patients, the different QL questionnaires used, the clinical results obtained, and the systematicrevisions available in the indexed literature for the last 10 years.The term QL appears as a keyword in an increasing number of articles throughout the past 10 years; however, fewstudies focus on oral cancer. Most of them assess all head and neck cancers, which conform to a heterogeneous groupwith several different features depending on location (oral cavity, oropharynx, larynx, hypopharynx, nasopharynx andsalivary glands). Most studies evaluate QL in short periods of time, normally within the first year after the diagnosis.Series do not discern between different therapeutic options, and they generally center on Northern European orNorthern American populations. There are few instruments translated and validated into Spanish that measure QL,a fundamental characteristic to link QL to own patients’ socio-cultural parameters. Data related with QL are mostlyrelated to patient (age, sex, co-morbidity), tumour (location, size), and treatment (surgical treatment, radiotherapyassociation, reconstruction, cervical dissection, and/or feeding tube). Nowadays QL’s assessment is considered anessential component of an oral cancer patient as well as the survival, morbidity and years free of disease. Althoughmany aspects related to QL in oral cancer patients have been published throughout the past 10 years, more systematicresearch is needed to be able to apply it on a daily basis (AU)

Mandibular ameloblastoma. A review of the literature and presentation of six cases.

Ameloblastoma is a benign odontogenic tumour of epithelial origin without induction in the connective tissue. In treating this type of tumour, it is important to assess the clinical type (solid, multicystic, unicystic, peripheral), localisation, and size of the tumour as well as age of the patient. Articles have recently been published with the purpose of providing updated knowledge and therapeutic approaches to ameloblastoma. We present six cases of patients with localised mandibular ameloblastoma who were treated during the last seven years. We present data on clinical appearance, histological characteristics, and therapeutic approach that was used, which included excision of the lesion, perilesional drilling of the bone, or block resection, according to the type of ameloblastoma. Lastly, we analysed follow-up measures and the rate of recurrence in these patients. The aim of this paper is to review the concepts relating to ameloblastoma that have been published recently and to assess their influence on the clinical attitude taken when facing this pathology, using our experience with ameloblastoma as a starting point to illustrate this discussion.

Geminación dental: presentación de un caso / Dental gemination: report of case

Las anomalías dentales pueden ser clasificadas en distintos grupos: anomalías de volumen, anomalías de número, anomalías de forma, anomalías de posición y anomalías por unión. Dentro de las últimas distinguimos entre fusión, geminación, concrescencia, coalescencia y anquilosis alvéolo-dentarias. La geminación es más frecuente en los dientes anteriores, aunque también puede afectar a premolares y molares, siendo una anomalía por unión infrecuente (prevalencia 0,5 por ciento). Presentamos el caso de un joven de 19 años sin antecedentes médicos de interés que acude a consulta por repetidos accidentes inflamatorios a nivel de la zona retromolar inferior izquierda. Estos episodios tienen su causa en un tercer molar inferior semi-incluido que se encuentra unido a un cuarto molar inferior supernumerario compartiendo raíz, corona, cámara y conductos pulpares. Tras el estudio radiológico oportuno y la planificación adecuada, el cordal semi-incluido fue extraído bajo anestesia local sin que se produjeran otras complicaciones durante o tras la intervención quirúrgica (AU)

Edema angioneurótico orofaríngeo causado por enalapril / Angioneurotic edema caused by ACEI: a case report

Aunque el consumo de fármacos inhibidores de la enzima convertidora de angiotensina presenta un bajo índice de efectos indeseables, en raras ocasiones se producers cuadros de edema angioneurótico localizados en el area orofacial y laríngea. El intervalo de aparición de este cuadro oscila entre las primeras horas y varios años desde el inicio de la toma del fármaco. Se presenta el caso de un hombre de 70 años, hipertenso, que desde hacía tres años tomaba enalapril. Fue ingresado en nuestro hospital por presentar un edema orolingual intenso, con dificultad para el lenguaje y disnea moderada. Se realizó un tratamiento con glucocorticoides, antihistamínicos y oxigenoterapia con mascarilla facial. No fue necesaria la intubación del paciente. El cuadro se resolvió a las 48-72 horas (AU)