Manejo clínico de la lengua negra vellosa / Black hairy tongue: clinical management

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Endovascular treatment of an intraosseous arteriovenous malformation of the mandible in a child. A case Report.

The modern application of interventional radiology techniques is revolutionizing the treatment of the vascular malformations of the head and neck. In fact, the morbidity related with the surgical extirpation of the malformation might be drastically reduced with the use of an endovascular approach. The present report describes the case of a 11 years old male affected by a large intraosseous arteriovenous malformation of the mandible. The coil embolization of the main drainage vein caused the spontaneous regression of the lesion and avoided a mutilating surgery and severe psychological sequels. A multidisciplinary approach of these case is mandatory. A careful clinical and radiological study of the patient is essential for a proper management. The choice of the treatment should be based on the location and extension of the malformation, age of the patient, experience with endovascular techniques and clinic. Key words:Endovacualr approach, intraosseous arteriovenous malformation, head and neck, child.

Leucoplasia verrucosa proliferativa de la lengua / Proliferative verrucous leukoplakia of the tongue

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Aneurysmal bone cyst of the mandible affecting the articular condyle: a case report.

Aneurysmal bone cyst (ABC) is a benign osteolytic lesion that is fast-growing, expansile, and locally destructive. The present case is of a young girl with facial asymmetry, which had become accentuated during the previous months. A conservative treatment was performed to reduce morbidity and affectation of the lower dental nerve.

Accidental displacement of a dental implant into the sublingual space: A Case report.

Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication. Key words:Dental implant, sublingual space, bone atrophy, complications of oral surgery.

Traumatic arteriovenous fistula as consequence of TMJ arthroscopic surgery. A case report.

UNLABELLED: The ocurrence of a traumatic arteriovenous fistula after arthroscopic surgery of TMJ represents an extremely rare event. Specifically, this uncommon complication has been described only in a few case reports. In this light, the most frequent symptoms showed by this disease are thrills, bruits, pulsatile tinnitus, and an expansible vascular mass. Importantly, the severity of these symptoms is also dependent on the vessels involved. With regard to the management, is important to note that the vessel ligation with surgery as well as vessel emolization with endovascular procedures have been shown to be effective in the treatment of these cases. In view of that, the present study describes a case of superficial temporal arteriovenous fistula that arose as a postoperative complication of a bilateral arthroscopic eminoplasty of TMJ. The aim of the present report is to characterize this rare syndrome with the goal of proposing suitable treatments. KEY WORDS: Arteriovenous fistula, arthroscopic surgery, eminoplasty of TMJ, temporal vessels.

Posttraumatic carotid-cavernous fistula: Pathogenetic mechanisms, diagnostic management and proper treatment. A case report.

UNLABELLED: Carotid-cavernous fistulas are an uncommon diseases characterized by abnormal communications between arteries and veins located in the cavernous sinus. According with Barrow´s classification they could be divided in two groups: direct and indirect. The typical symptoms showed by theses pathologies are: pulsating exophthalmos and orbital blow. The present study describes a case of direct posttraumatic carotid-cavernous fistula in a 26 years old man. Furthermore, we present the images that we used to make the diagnosis. In this light, we decided to treat this case with endovascular approach after considering several therapeutic options. The aim of the present report is twofold. First, we examine the importance of the proper management of the direct posttraumatic carotid-cavernous fistula. Second, we describe this rare syndrome with the goal of proposing suitable treatments. KEY WORDS: Carotid cavernous fistulas, pulsating exophthalmos, orbital blow, endovascular approach, Barrow´s classification.

Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid.

Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy.

Condromatosis sinovial de la articulación temporomandibular con extensión a la base de cráneo / Synovial chondromatosis of the temporomandibular joint. a rare case with subcranial extension

La condromatosis sinovial (CS) es una metaplasia cartilaginosa de los remanentes mesenquimales del tejido sinovial de las articulaciones. Es una enfermedad de etiología desconocida y poco frecuente. Puede definirse como un proceso benigno sinovial caracterizado por la formación de nódulos cartilaginosos (cuerpos libres). La CS afecta principalmente a grandes articulaciones sinoviales siendo poco común su aparición en la articulación temporomandibular. La sintomatología predominante es dolor, inflamación, limitación de los movimientos mandibulares, crepitación y laterodesviación mandibular. El diagnóstico se realiza mediante el estudio radiológico y artroscópico de la articulación. El tratamiento adecuado englobaría la extirpación completa de los cuerpos libres y de la sinovial afecta, bien mediante artroscopia o mediante cirugía abierta. Cuando está afectada la articulación temporomandibular las lesiones suelen estar localizadas en la cavidad articular, siendo rara su extensión extraarticular. En este artículo describimos un caso excepcional de condromatosis sinovial con extensión a la fosa craneal media(AU)

Synovial chondromatosis (SC) is a cartilaginous metaplasia of the mesenchymal remnants of the synovial tissue of joints. It is an uncommon disease of unknown origin. This benign synovial process involves the formation of cartilaginous nodules (loose bodies) in the synovium and within the articular space. SC mainly affects large synovial joints, and only very rarely affects the temporomandibular joint (TMJ). The main symptoms are pain, swelling, mouth opening limitation, crepitation, and lateral mandibular deviation. Diagnosis can be made by panoramic radiograph, computed tomography scan, magnetic resonance imaging, and arthroscopy of the TMJ. The main treatment includes complete removal of the loose bodies in conjunction with excision of the affected synovium. It can be performed by arthroscopy or by open surgery. In cases with TMJ involvement, the lesion is usually confined to the joint cavity. In this report, a rare case of SC of the TMJ with subcranial extension is presented(AU)

A combined approach for the assessment of cell viability and cell functionality of human fibrochondrocytes for use in tissue engineering.

Temporo-mandibular joint disc disorders are highly prevalent in adult populations. Autologous chondrocyte implantation is a well-established method for the treatment of several chondral defects. However, very few studies have been carried out using human fibrous chondrocytes from the temporo-mandibular joint (TMJ). One of the main drawbacks associated to chondrocyte cell culture is the possibility that chondrocyte cells kept in culture tend to de-differentiate and to lose cell viability under in in-vitro conditions. In this work, we have isolated human temporo-mandibular joint fibrochondrocytes (TMJF) from human disc and we have used a highly-sensitive technique to determine cell viability, cell proliferation and gene expression of nine consecutive cell passages to determine the most appropriate cell passage for use in tissue engineering and future clinical use. Our results revealed that the most potentially viable and functional cell passages were P5-P6, in which an adequate equilibrium between cell viability and the capability to synthesize all major extracellular matrix components exists. The combined action of pro-apoptotic (TRAF5, PHLDA1) and anti-apoptotic genes (SON, HTT, FAIM2) may explain the differential cell viability levels that we found in this study. These results suggest that TMJF should be used at P5-P6 for cell therapy protocols.

Distracción ósea: tratamiento de la apnea obstructiva en neonatos con micrognatia / Mandibular distraction: treatment of obstructive apnea in neonates with micrognathia

Las malformaciones craneofaciales (secuencia de Pierre Robin, síndrome de Threacher-Collins, síndrome de Nager, etc.) con frecuencia van asociadas a hipoplasia mandibular grave, que puede causar obstrucción de la vía aérea superior por retroposición de la base de la lengua dentro del espacio faríngeo posterior. La mayoría de los pacientes responden al tratamiento postural, en decúbito prono, puede ser necesario controlar la saturación de oxígeno, insertar un tubo nasofaríngeo e incluso intratraqueal. En casos más graves con pausas prolongadas y frecuentes de apnea, la traqueostomía puede ser necesaria, pero se asocia a una alta morbilidad y, ocasionalmente, mortalidad. En los últimos 2 años, en la Unidad Multidisciplinaria de Labio y Fisura Palatina del Hospital Virgen de las Nieves de Granada, se ha tratado a 4 niños con apnea obstructiva grave secundaria a hipoplasia mandibular grave mediante distracción mandibular osteogénica, y este procedimiento se ha mostrado eficaz en la resolución del problema. Ha evitado la traqueostomía y se ha elongado la mandíbula en el plazo de 3-4 semanas. En este tiempo han desaparecido los problemas respiratorios obstructivos, así como también de la deglución, y los resultados estéticos obtenidos han resultado excelentes y las complicaciones, por el momento, mínimas(AU)

Craniofacial malformations (Pierre-Robin sequence, Treacher-Collins syndrome, Nager syndrome, etc.) are frequently accompanied by severe mandibular hypoplasia, which can cause upper airway obstruction due to retroposition of the base of the tongue in the posterior pharyngeal space. The majority of patients respond to postural treatment in decubitus prono. It may be necessary to monitor oxygen saturation and insert a nasopharyngeal or even an endotracheal tube. Tracheostomy may be necessary in more serious cases with long and frequent apnea pauses, but it is associated with high morbidity and occasional mortality. In the last two years, four children with severe obstructive apnea secondary to mandibular hypoplasia were treated by means of "osteogenic mandibular distraction" in the multidisciplinary Cleft Palate Department of Virgin de las Nieves Hospital (Granada, Spain). This procedure effectively resolved the problem, making tracheostomy unnecessary and lengthening the jaw within 3-4 weeks; in this period, obstructive respiratory problems and swallowing difficulties disappeared. The aesthetic results were excellent and the complications so far have been minimal. Objective: To present the results of a patient series with several types of POP treated using the same approach and operation(AU)