What is the frequency of floor of the mouth lesions? A descritive study of 4016 cases / ¿Cuál es la frecuencia de las lesiones del suelo de la boca? Un estudio descriptivo de 4016 casos

Background: The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth fromrepresentative oral pathology centres in Latin America.Material and Methods: This study was conducted on biopsies obtained from January of 1978 to December of 2018at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis wereevaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons.Results: From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases(94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases),followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964) cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The mostcommon histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oralleukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in2,129 cases and females in 1,897 cases.Conclusions: In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oralpathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions.(AU)

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.

Cinco años de seguimiento de tratamiento no invasivo para lesiones auto-infligidas en un niño con parálisis cerebral / Five year follow-up of non-invasive treatment for self-inflicted oral trauma in a child with cerebral palsy

ABSTRACT Introduction: Cerebral palsy involves loss or impairment of motor function attributed to non-progressive disturbances occurring in the developing fetal or infant brain. Self-inflicted oral trauma is a recurrent parafunctional habit in individuals with cerebral palsy. Objective: Describe two treatment modes for self-inflicted oral trauma in a 6-year-old male patient with cerebral palsy over a 5-year follow-up period. Case presentation: The child had been having pain due to injuries to the mouth floor and lingual frenum regions. Initially, low-level laser therapy was applied to accelerate the healing process of the wounds. Five years later, the child started to present worse oral injuries and placement of a fixed oral appliance was proposed. Intraoral examination showed that the wounds had healed completely in response to the oral appliance. Conclusions: Different therapies may be useful to control the recurrence of self-inflicted oral injuries(AU)

RESUMEN Introducción: La parálisis cerebral provoca una pérdida o deterioro de la función motora atribuida a trastornos no progresivos del desarrollo cerebral fetal o infantil. La lesión autoinfligida es un hábito parafuncional recurrente en personas con parálisis cerebral. Objetivo: Describir dos modalidades de tratamiento para las lesiones autoinfligidas en un niño de 6 años de edad con parálisis cerebral durante un periodo de seguimiento de 5 años. Presentación del caso: El niño presentaba dolor debido a lesiones en la región del suelo de la boca y el frenillo lingual. Inicialmente se aplicó terapia con láser de baja intensidad para acelerar el proceso de cicatrización de las heridas. Cinco años más tarde el niño empezó a presentar lesiones bucales más severas, por lo que se propuso la colocación de un dispositivo oral fijo. El examen intraoral mostró que las lesiones habían cicatrizado completamente en respuesta al dispositivo oral instalado. Conclusiones: Diferentes terapias pueden ser útiles para controlar la recurrencia de las lesiones orales autoinfligidas(AU)

[Oral metal foreign bodies]. / Corps étranger métallique de la cavité buccale.

Oral foreign bodies are most encountered in children. They rarely pose diagnostic problems. But the therapeutic management can use the therapeutic escalation from simple extraction chair to extraction per endoscopic under general anesthesia. We report an unusual case of metal foreign body (umbrella's support) penetrating the oral cavity and measuring 18 cm long in a 5 years-old boy. A radiograph of skull centered on the mouth as great interest in the diagnostic and particulary in the management of the metallic foreign body. The extraction of foreign body was done by oral approaches under general anesthesia.

Variation in arterial supply to the floor of the mouth and assessment of relative hemorrhage risk in implant surgery.

OBJECTIVES: Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space: clinicians may injure the submental and sublingual arteries, which originate from the facial and lingual arteries, respectively. This study aimed to clarify the three-dimensional courses of submental and sublingual arteries and their topographic relation to the mandible. MATERIALS AND METHODS: During the gross anatomy course at the Faculty of Dentistry and Graduate School, Niigata University (2009-2011), we investigated the relationship between the courses of submental and sublingual arteries and their dividing patterns of the mylohyoid muscle, sublingual gland, and mandible using 27 human cadavers. RESULTS: The courses of submental and sublingual arteries were divided into four patterns: (1) the sublingual space was supplied by the sublingual artery (type I: 63%), (2) it was supplied by both the sublingual and submental arteries (type II: 5.6%), (3) it was supplied by the submental artery without the sublingual artery (type III: 29.6%), and (4) type III without the deep lingual artery originated from the lingual artery (type IV: 1.8%). In type II, III, and IV, the submental artery perforates the mylohyoid muscle or takes a roundabout route to travel near the surface of the mandible. The percentage occurrence of arteries traveling between the sublingual gland and mandible in type II, III, and IV (55%) is higher than that in type I (8.8%). CONCLUSION: Susceptibility of the submental artery in type II, III, and IV to injury during implant surgery is suggested.

Epidemiology of maxillofacial injury in children under 15 years of age in southern China.

OBJECTIVE: This retrospective study was conducted to report the epidemiology of maxillofacial injuries of children <15 years old in China. STUDY DESIGN: Data collected in this study included age, sex, etiology, date of injury, anatomic site of injury, and treatment modality. Regarding treatment, conservative technique and surgery were both used. The analyses involved were descriptive statistics and χ(2) test. RESULTS: There were 335 men and 135 women, with a gender ratio of 2.48:1. Bicycle accident was the leading cause of injury. The common sites of soft tissue injury included gingiva, chin, lip, cheek, palate/pharynx, and tongue/mouth floor. In addition, the mandible was most involved in facial skeleton injury. Conservative treatment was generally preferred for such pediatric patients. CONCLUSIONS: Boys were prone to be victims of maxillofacial trauma. Preventive measures should be applied both indoors and outdoors. Patients in the growing phase should be monitored periodically to detect and prevent early facial asymmetry or malocclusion.

A toothbrush impalement injury of the floor of mouth in autism child.

Penetrating injuries in the oral cavity are common in children. However, penetrating injuries with retained foreign bodies are rare. We report a case of a toothbrush impalement injury of the floor of the mouth in a child with autism. A 5-year-old boy with autism presented with an accidentally impaled toothbrush in the oral cavity. He was taken to the operation room and examined under general anesthesia. The handle of the toothbrush was cut off using rib scissors for mask ventilation, and intra-oral intubation was performed. The toothbrush was located approximately 2.5 cm into the floor of the mouth. The toothbrush was removed uneventfully. Intravenous antibiotic therapy was instituted during hospitalization, and discharge from the hospital occurred 4 days after the operation.

Aesthetic and anatomic subunit reconstruction of composite mandibular gunshot wound.

BACKGROUND: Gunshot facial traumas involving the mandible and surrounding soft tissues are represented by the potential for loss of relationships between the functional and the aesthetic subunits of the head. METHODS: A patient presented with an 8-cm composite mandibular defect, resulting from a self-inflicted gunshot injury. Taking into account the anatomic/aesthetic subunits involved, a fibular osseoseptocutaneous flap was transferred to reconstruct the left lateral mandibular segment and the floor of the mouth, whereas a preexpanded temporal scalp flap was transferred to restore the hair-bearing skin of the left buccomandibular subunit. A review of the literature is also presented. RESULTS: A satisfactory functional and aesthetic outcome was achieved. Although current literature supports the value of aesthetic subunit face reconstruction and the use of double flaps for the reconstruction of through-and-through oromandibular defects, there is no previous report of the combined use of temporal scalp flap and fibular osseocutaneous flap. CONCLUSIONS: The combined use of hair-bearing skin and osseocutaneous flap may achieve optimal results in through-and-through oromandibular defects.

Don't hang your coat here.

Report 2 cases of coat hanger floor of mouth injuries in children. We describe 2 cases of children who presented with coat hanger impalement injuries of the floor of mouth and their management. Removal under anesthesia is safe with a period of observation postoperatively. Impalement injury with coat hangers in the head and neck is a rarely encountered or described mechanism of trauma. We report the first case series of coat hanger impalement injuries in the floor of mouth in two children. Plain film radiographs may be useful to determine the depth of injury and trajectory of the foreign body. Careful removal under anesthesia is safe. Little if any floor of mouth edema was encountered postoperatively, but close observation for potential critical floor of mouth hematoma or edema should be considered.

Quiste dermoide del suelo de la boca / Dermoid cyst in the mouth floor

El quiste dermoide representa menos del 0,01 por ciento de todos los quistes de la cavidad bucal. Su ubicación más frecuente es en suelo de boca. Se presenta el caso de una paciente femenina de 19 años de edad que hacía aproximadamente 7 años había notado un aumento de volumen debajo de la lengua, el cual le crecía paulatinamente y ya se apreciaba por fuera de la cara. Además, le ocasionaba molestias al hablar y al masticar. Se realizaron estudios complementarios y bajo anestesia general nasotraqueal. Se procedió a su exéresis quirúrgica mediante un abordaje intrabucal, donde se obtuvieron excelentes resultados estéticos y funcionales. El diagnóstico histopatológico se correspondió con un quiste dermoide de suelo de boca. La paciente no ha tenido recurrencia de la lesión transcurridos tres años de la operación. El quiste dermoide de suelo de boca se presenta como una tumoración benigna de la línea media. La exéresis intrabucal demuestra beneficios estéticos y funcionales(AU)

The Dermoid cyst account for the 0.01 percent of all cysts of buccal cavity. Its more frequent location is in the mouth floor. This is the case of a female patient aged 19 who approximately 7 years noted an increase of volume under tongue growing gradually and noting outside face and the discomfort at to speak and to chew. Complementary studies were conducted and under general anesthesia a surgical exeresis was carried out by intrabuccal approach achieving excellent esthetic and functional results. Histopathologic diagnosis matched with a dermoid cyst of mouth floor. Patient has not lesion recurrence after three years after operation. We conclude that the Dermoid cyst of mouth floor appear as benign tumor of middle line. The intrabuccal exeresis demonstrates esthetic and functional benefits(AU)

Cuerpo extraño inusual en el suelo de la boca / Unusual foreign body on mouth floor

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Management outline of oral and maxillofacial missile injuries in Iraq: the value of the intermediate phase.

Oral and maxillofacial surgeons in Iraq are practicing in a paradoxical situation where a high number of extensive injuries are accompanied by limited resources. Steps of management should be followed cautiously in attempts to reduce residual deformities that characterize the end results of severe missile injuries. This study elucidate lessons extirpated from surgical experience in the management of diversity of causalities with special emphasis on the intermediate phase of management as well as different modalities of treatment, trying to get best benefit from available resources.

Unassisted childbirth or homicide--different appraisals of severe injuries in a newborn.

A case of a 24-year-old woman who gave birth to a mature newborn is reported. Many injuries at the head, neck and shoulders, back, mouth and throat which at least partly indicated unassisted childbirth were observed during autopsy. Some injuries, especially the different scull fractures were discussed controversially on trial. One expert postulated a coaction of unassisted childbirth and blunt head trauma to be responsible for the exitus. The other expert considered it possible that all injuries could originate from unassisted childbirth. The court consented to the opinion that all injuries could be the consequence of unassisted childbirth and the woman was exculpated from the accusation of manslaughter.

Blood collection from the sublingual vein in mice and hamsters: a suitable alternative to retrobulbar technique that provides large volumes and minimizes tissue damage.

Blood examination is a key element in studies of laboratory animals. In rodents, retrobulbar venous plexus puncture is a commonly used method for obtaining a blood sample. Although this technique yields large volumes of blood, the disadvantage is that it can lead to severe tissue damage. The aim of the present study was to develop the puncture of V. sublingualis as a suitable alternative technique for drawing blood in mice and other rodents. In rats, this method has been established for collecting large blood volumes. During the first part of the study, the sublingual bleeding technique was developed for use in mice and hamsters. Guinea pigs, however, do not have a sublingual vein; therefore, in this species the method is not possible. In the second part of the study, retrobulbar and sublingual methods were compared using male CD-1 mice. When compared with the retrobulbar method, sublingual venepuncture showed less tissue destruction in mice, with a decreased mean severity in the histological examination. In conclusion, sublingual venepuncture can be recommended as a suitable, alternative blood collection technique, because of the reduced risk of tissue damage in mice and hamsters.

Hematoma of the floor of the mouth and airway obstruction during mandibular dental implant placement: a case report.

BACKGROUND: Hematoma of the floor of the mouth during mandibular dental implant placement is a rare but potentially life-threatening complication. REPORT: A 53-year-old man developed a hematoma of the floor of the mouth following a dental implant procedure, requiring admission to the hospital. SUMMARY: The floor of the mouth is richly vascularized by a number of branches of the submental and sublingual arteries. During a dental implant procedure in the anterior zone of the mandible, perforation of the lingual cortex may invade the floor of the mouth and therefore damage structures within the sublingual space. The anatomy of the lower portion of the anterior mandibular zone, with the mylohyoid ridge, makes it particularly vulnerable to this kind of injury, particularly in patients with atrophic mandibles. Only a few cases have been reported in the literature to date.