Comparison of the Clinical Effectiveness of Intra-Articular Injection with Different Substances After TMJ Arthroscopy: A Systematic Review and Meta-Analysis.

Objective: This systematic review aims to describe the clinical outcomes after TMJ arthroscopy followed by intra articular infiltration with different substances. Materials and Methods: A literature search was carried out, the variables were Arthroscopy with different substances, pain and maximal mouth opening. The inclusion criteria were articles that reported infiltration of different substances after arthroscopy. Case series, observational studies, and randomized clinical trials were included. Exclusion criteria were studies that included arthrocentesis, animal studies, connective tissue disease, patients with previous surgeries. Results: Of the 5 studies finally included, the population studied were 346 subjects, of which 315 were female. The mean age was 34.7 (16-77). Regarding diagnoses, Wilkes III and Wilkes IV were taken into account. The most commonly used substance was sodium hyaluronate/hyaluronic acid in 4 of the 5 studies. Conclusion: Multiple substances have been infiltrated within the temporomandibular joint, with sodium hyaluronate/hyaluronic acid being the most studied. However, the benefit of substances like ATM artroscopia adyuvantes has not been clearly established. It is recommended in future studies that the substances and results be evaluated in the same way to obtain more homogeneous studies.

Gnathic Schwannomas: A Report of Two Cases and Systematic Review of the Literature.

BACKGROUND: The intraosseous schwannoma (IS) is a benign peripheral nerve sheath tumor postulated to arise de novo or from nerve fibers in preexisting nutrient canals. ISs are uncommon and comprise less than 1% of neoplasms originating in bone. We herein present two cases of mandibular schwannomas-the first case was a 66-year-old female with a four-month history of pain and pressure associated with an anterior mandibular radiolucency, and the second case was an asymptomatic 12-year-old female with separate radiolucencies of her mandibular symphysis and right posterior mandible. Incisional biopsies of all three lesions showed a benign spindle cell neoplasm with histologic features of a schwannoma; the tumor cells were strongly reactive for S-100. The patients underwent complete enucleation of their lesions and are without evidence of disease at ten months and five years, respectively. METHODS: A systematic review was undertaken to evaluate the diagnostic features, treatment, and patient outcomes of gnathic schwannomas. RESULTS: A total of 93 cases were identified with the following demographic findings: predominance in females (57%); average age of occurrence of 37.3 years (8 to 77 years); mean size of 3.6 cm; and involvement of the mandibular body (37.6%), mandibular body and ramus (18.3%), and anterior mandible (18.3%). The predominant clinical sign was swelling (69.9%), and the most common radiographic presentation was a radiolucency (94.6%) with well-defined borders (72%). CONCLUSION: All cases were treated surgically, with an average follow-up interval of 22.9 months and a recurrence rate of 5.4.

Oral mucosal lesions in patients with SARS-CoV-2 infection. Report of four cases. Are they a true sign of COVID-19 disease?

BACKGROUND: Vesiculobullous and macular lesions in the oral mucosa have been reported in patients positive for SARS-CoV-2 infection. Nonetheless, the significance and physiopathology of oral manifestations have not been clearly established in the clinical progression or outcome of the infection. AIM: To describe the clinico-pathological oral mucosal lesions in four patients with confirmed SARS-CoV-2 infection. METHODS AND RESULTS: Four patients with COVID-19 disease and confirmed by polymerase chain reaction (PCR) presented angina bullosa hemorragica-like lesion, vascular disorder, and nonspecific stomatitis, one patient with histological analysis demonstrated perivascular reactive lymphocitic infliltrate, focal capillary thrombosis, and hemorrhage. According to the discrimination of other local and systemic conditions and the synchronous onset of oral and systemic symptoms, the diagnosis of oral lesions probably associated with COVID-19 was established. CONCLUSION: Infection with SARS-CoV-2 may result in oral manifestations with various clinical presentations, which presumably support the hypothesis of thrombi formation and vasculitis; nevertheless, these findings need more evidence and a long-term follow up of patients to accurately establish the significance of the oral mucosa affection in the COVID-19 disease.