Osteoblastoma of the Hard Palate in a Child: A Rare Case.

Benign osteoblastoma is a rare bone tumour characterised histologically by the production of woven bone spicules, which are bordered by prominent osteoblasts. It mainly affects young adults. We report a rare case of benign osteoblastoma of the maxilla in a 7-year-old boy who presented with a painful swelling on the left hard palate. An incisional biopsy was interpreted as osteoblastic neoplasm most suggestive of osteoblastoma. After excision of the tumour there has been no recurrence for 2 years.

Aplasia of the lacrimal and major salivary glands (ALSG). First case report in spanish population and review of the literature.

Aplasia of the lacrimal and the major salivary glands (ALSG) is a rare disorder with scarce cases described in the recent literature. The pattern of genetic inheritance is autosomal dominant with variable expressivity. A 40 years male patient was referred to the Oral and Maxillofacial Service at the Hospital Universitario de A Coruña diagnosed with complete agenesis of all salivary glands. Our case it is the first of ALSG syndrome in the Spanish literature. Imaging tests are necessary to confirm the lack of formation of salivary glands and alteration of lacrimal system. A mutation of FGF10 has been proposed as the responsible of the syndrome. The management of the lacrimal alteration depends of the clinical findings. Clinical suspicion remains the principal tool to diagnose the syndrome. Key words:ALSG, salivary glands aplasia.

Reconstrucción mandibular con el colgajo pediculado osteofascial parietal bicortical: nuestra experiencia en 9 casos / Mandibular reconstruction with the bicortical parietal osteofascial pedicled flap: our experience in 9 cases

Objetivo. Describir las ventajas y desventajas del colgajo pediculado osteofascial parietal bicortical en la reconstrucción mandibular, mostrando nuestra experiencia en 9 casos. Material y métodos. Estudio retrospectivo de 9 casos consecutivos a los que se les realizó una reconstrucción ósea segmentaria mandibular con un colgajo pediculado osteofascial parietal bicortical. Se describen las indicaciones, la técnica, los resultados y las complicaciones, así como los datos clínicos más relevantes de los pacientes. Resultados. El tamaño del defecto óseo reconstruido osciló entre 3,5 y 11 cm de largo (media 7 cm), y entre 2 y 4 cm de alto (media 3 cm). El tamaño del componente óseo del colgajo se correspondía aproximadamente con las dimensiones del defecto óseo mandibular. En todos los casos el colgajo fue viable. La incidencia de complicaciones fue alta, presentando dehiscencia en la zona donante dos tercios de los pacientes, requiriendo la reconstrucción del defecto 4 de ellos (44%). La zona receptora presentó diversas complicaciones, por lo que se precisó la reconstrucción con colgajos locales en 2 casos (22%). Conclusión. El colgajo pediculado osteofascial parietal bicortical aporta a la reconstrucción mandibular un hueso membranoso vascularizado bicortical obtenido de una zona próxima a la receptora. Dicho colgajo puede ser una alternativa a las técnicas microquirúrgicas cuando estas no estén disponibles o no sean aplicables, y a la distracción osteogénica mandibular mediante transporte óseo. Las complicaciones en la zona donante de este colgajo, aun no siendo graves, pueden requerir cirugías de revisión (AU)

Objective. To describe the advantages and disadvantages of segmental mandibular bone reconstruction with the bicortical parietal osteofascial pedicled flap, showing our experience in 9 cases. Material and methods. Retrospective study of 9 consecutive patients undergoing segmental mandibular bone reconstruction with a bicortical parietal osteofascial pedicled flap. Indications, technique, results and complications as well as the most relevant clinical data of patients are described. Results. The size of the reconstructed bone defect was from 3.5 to 11 cm of long (average 7 cm), and from 2 to 4 cm of high (average 3 cm). The size of the bone flap component corresponded approximately to the dimensions of the mandibular bone defect. In all cases the flap was viable. The incidence of complications was high, showing dehiscence at the donor site in two thirds of patients, requiring reconstruction of the defect in 4 patients (44%). The receiving area presented various complications, requiring reconstruction with local flaps in 2 cases (22%). Conclusion. The bicortical parietal osteofascial pedicled flap gives to the mandibular reconstruction a vascularized membranous bicortical bone. It also presents the advantages associated with being a close flap. This flap can be an alternative to microsurgical techniques when these are not available or they are not applicable and to the mandibular distraction osteogenesis by bone transport. Complications in the donor area of this flap, although not serious, may require revision surgery (AU)

A sheep model for endoscopic treatment of mandible subcondylar fractures.

BACKGROUND: Mandible subcondylar fractures may be treated via a traditional visible access incision; however, with the advances in surgical endoscopy surgeons are transitioning to a minimally invasive approach in an effort to reduce surgical morbidity and external facial scarring. We sought to design a clinically applicable teaching tool in a large animal model that would allow the operator to gain experience treating mandible subcondylar fractures via an endoscopic approach. METHODS: A large animal model was developed using the Churra sheep. Subcondylar fractures were created, reduced, and internally plated in ten specimens via an extraoral, two-port endoscopic approach. Animals were monitored for surgical success during the intraoperative and immediate postoperative periods. RESULTS: Mandibles were reduced and fixated successfully in each of the animals. Operative time was reduced from 70 to 40 min as the surgeons became more familiar with the surgical procedure. Each of the ten Churra sheep used in the study tolerated the surgeries without postoperative complications. CONCLUSIONS: Capitalizing on a mandibular anatomy similar to humans, the Churra sheep successfully demonstrated utility for the extraoral, endoscopic approach in treating mandibular condyle fractures. This model offers surgeons the opportunity to gain surgical endoscopic experience before treating clinical patients.

Vascular Lesions: GLUT-1 expression as a diagnostic tool to discriminate tumors from malformations.

Vascular lesions constitute a widely heterogeneous group of tumors and malformations. For head and neck vascular anomalies, most studies have not attempted to make the differential diagnosis between true hemangiomas and vascular malformations, because an accurate diagnosis remains a challenge for physicians. The successful treatment of vascular anomalies depends on a profound knowledge of their biologic behavior and correct classification. Recently, specific immunohistochemical markers such as erythrocyte-type glucose transporter protein 1 have been described to differentiate hemangiomas from vascular malformations. This report describes 2 cases of intramuscular vascular anomalies involving the masseter muscle histologically diagnosed primarily as cavernous hemangiomas and presents the imaging and pathologic findings. Ample surgical excision was performed through an intraoral approach. Immunohistochemistry showed no uptake of glucose transporter protein 1. The literature was reviewed and the designation intramasseteric vascular malformation for this entity is proposed.

A comparative study of platelet-rich plasma, hydroxyapatite, demineralizedbone matrix and autologous bone to promote bone regeneration after mandibularimpacted third molar extraction

Objectives: 1) to compare mandibular bone regeneration by applying autologous bone, platelet-rich plasma andtwo biomaterials (synthetic calcium hydroxyapatite, and demineralized bone matrix), and thus establish the potentialbenefits of these biomaterials in the regeneration of postextraction alveolar bone, 2) to identify wich of themaccelerates more bone regeneration and 3) to determine whether there are differences in the postoperative period(pain, swelling, trismus, infection) depending on the material used.Study Design: It consists in a prospective, controlled (with a split- mouth design) and double blinded study. We useas a model an easily reproducible non-critical bone defect: the defect that remains after extraction of mandibularimpacted third molar. The study design is based on the extraction of two mandibular impacted third molars ina patient during the same surgical procedure by the same surgeon. We assessed postoperative clinical data, andshort, medium and long term neoformation of alveolar bone after extraction. We compared the two sockets (rightand left), which had been grafted in a different way with the various elements mentioned above. In addition, wecompared the postoperative inflammatory symptoms between groups.Results: The highest acceleration in bone formation was observed in groups in which we used autologous boneand demineralized bone matrix. There were no statistically significant differences between groups regarding pain,swelling, trismus and infection throughout the postoperative period.Conclusions: According to the results of our study, autologous bone persists as the gold standard material for boneregeneration. Among the assessed biomaterials, demineralized bone matrix has yielded the best results obtained.No significant differences in the postoperative (pain, swelling, trismus and infectious events) were observed, dependingon the type of material used as a graft (AU)

No disponible

A comparative study of platelet-rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction.

OBJECTIVES: 1) to compare mandibular bone regeneration by applying autologous bone, platelet-rich plasma and two biomaterials (synthetic calcium hydroxyapatite, and demineralized bone matrix), and thus establish the potential benefits of these biomaterials in the regeneration of postextraction alveolar bone, 2) to identify which of them accelerates more bone regeneration and 3) to determine whether there are differences in the postoperative period (pain, swelling, trismus, infection) depending on the material used. STUDY DESIGN: It consists in a prospective, controlled (with a split- mouth design) and double blinded study. We use as a model an easily reproducible non-critical bone defect: the defect that remains after extraction of mandibular impacted third molar. The study design is based on the extraction of two mandibular impacted third molars in a patient during the same surgical procedure by the same surgeon. We assessed postoperative clinical data, and short, medium and long term neoformation of alveolar bone after extraction. We compared the two sockets (right and left), which had been grafted in a different way with the various elements mentioned above. In addition, we compared the postoperative inflammatory symptoms between groups. RESULTS: The highest acceleration in bone formation was observed in groups in which we used autologous bone and demineralized bone matrix. There were no statistically significant differences between groups regarding pain, swelling, trismus and infection throughout the postoperative period. CONCLUSIONS: According to the results of our study, autologous bone persists as the gold standard material for bone regeneration. Among the assessed biomaterials, demineralized bone matrix has yielded the best results obtained. No significant differences in the postoperative (pain, swelling, trismus and infectious events) were observed, depending on the type of material used as a graft.

Oral leiomyoma in retromolar trigone. A case report.

Leiomyomas are bening tumours originated on smooth muscle. The most frequent site of appearance are uterine myometrium, gastrointestinal tract and skin. The highest incidence occurs between 40 and 49 years of age. Its presentation is unusual in children or in older patients. Leiomyomas are unfrequent in the oral cavity, but in this location are usually localized on tongue, lips and palate. Leiomyomas use to appear as well-defined masses, with slow growth and totally asymptomatic. Pain is present just in rare cases. The treatment is surgical escision. Recurrences are extremely unfrequent. The diagnosis is mainly determined by histological studies due to its unspecific clinical appearance. Histopathologically proliferation of smooth muscle cells is observad without necrotic areas. A low number of mitotic figures can be seen. We present the case report of a 25-year old male patient, with a leiomioma on his right retromolar trigone. The low incidence of this pathology, the age of the patient and the unusual location, make the report of the case worthy.

Oral leiomyoma in retromolar trigone. A case report

Los leiomiomas son tumores benignos originados en el músculo liso. Su localización más frecuente es el útero, el tracto gastro-intestinal y la piel. Se presenta habitualmente entre los 40 y 49 años de edad, siendo muy rara su aparición en la infancia y en la senectud. Son muy infrecuentes a nivel de la cavidad oral, pero cuando se dan en esa localización, asientan principalmente en la lengua, los labios o el paladar. Inicialmente suelen presentarse como una masa muy bien definida, de lento crecimiento y totalmente asintomática. En raras ocasiones producen dolor. Su tratamiento es casi siempre quirúrgico, siendo las recurrencias excepcionales. Dada su clínica inespecífica, su diagnóstico es principalmente histológico, observándose en las muestras una proliferación de células musculares lisas, sin focos de necrosis y con escasas mitosis. Presentamos el caso clínico de un paciente de 25 años de edad con un leiomioma en trígono retromolar derecho. Dada la escasa incidencia de este tipo de patología, la edad del paciente y su inusual ubicación, se justifica la presentación de este caso

Leiomyomas are bening tumours originated on smooth muscle. The most frequent site of appearance are uterine myometrium, gastrointestinal tract and skin. The highest incidence ocurs between 40 and 49 years of age. Its presentation is unusual in children or in older patients. Leiomyomas are unfrequent in the oral cavity, but in this location are usually localized on tongue, lips and palate. Leiomyomas use to appear as well-defined masses, with slow growth and totally asymptomatic. Pain is present just in rare cases. The treatment is surgical escision. Recurrences are extremely unfrequent. The diagnosis is mainly determined by histological studies due to its unspecific clinical appearance. Histopathologicaly proliferation of smooth muscle cells is observad without necrotic areas. A low number of mitotic figures can be seen. We present the case report of a 25-year old male patient, with a leiomioma on his right retromolar trigone.The low incidence of this pathology, the age of the patient and the inusual location, make the report of the case worthy

Neurofibroma plexiforme en mucosa yugal: Presentación de un caso clínico / Plexiform neurofibroma of the cheek mucosa. A case report

Presentamos un caso clínico de neurofibroma plexiforme localizado en región geniana, a nivel submucoso. Su interés radica en que, a pesar de ser el tumor de origen neurógeno más frecuente, es una entidad poco habitual y que rara vez se localiza a nivel intraoral. Por otra parte, la variedad plexiforme es todavía menos frecuente. Desde el punto de vista clínico, se manifiestan como lesiones anodinas, con escasa sintomatología, que cuando aparece es derivada de la compresión nerviosa. En nuestro caso el tumor era asintomático salvo por el tamaño. Radiológicamente no existe una imagen definitiva. Tiene relación con determinados síndromes poliglandulares y facomatosis. El tratamiento es básicamente quirúrgico aunque existen dudas de la idoneidad del mismo y se están buscando nuevas vías de tratamiento. Aprovechando la descripción del caso se realiza una revisión bibliográfica incidiendo en la epidemiología, comportamiento clínico, métodos diagnósticos, así como en el tratamiento de este tipo de tumores benignos (AU)

The case reported deals with a solitary plexiform neurofibroma affecting the cheek submucosa. Neurofibroma is an uncommon tumor which rarely appears in oral cavity but it represents the most common neurogenic tumor. Furthermore, plexiform variety is less frequent. Clinically, oral neurofibromas usually apperars as anodyne and asintomatic lesions. Sometimes, they produce nervous compression. In this case, tumor is big but asintomatic. There is no definitive radiologic image. It has association with poliglandular syndroms and phacomatosis. The treatment of choice is excision. There are doubts of the surgical results so that some authors are looking for new non-surgical treatments. The clinical characteristics, epidemiology, diagnosis and treatment are described as soon as a bibliographic revisión (AU)

Plexiform neurofibroma of the cheek mucosa. A case report.

The case reported deals with a solitary plexiform neurofibroma affecting the cheek submucosa. Neurofibroma is an uncommon tumor which rarely appears in oral cavity but it represents the most common neurogenic tumor. Furthermore, plexiform variety is less frequent. Clinically, oral neurofibromas usually appears as anodyne and asintomatic lesions. Sometimes, they produce nervous compression. In this case, tumor is big but asintomatic. There is no definitive radiologic image. It has association with polyglandular syndromes and phacomatosis. The treatment of choice is excision. There are doubts of the surgical results so that some authors are looking for new non-surgical treatments. The clinical characteristics, epidemiology, diagnosis and treatment are described as soon as a bibliographic revisión.