Effect of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on the incidence of alveolar osteitis following the extraction of mandibular third molars. A double-blind randomized clinical trial.

UNLABELLED: Alveolar osteitis (AO) is a common complication after third molar surgery. One of the most studied agents in its prevention is chlorhexidine (CHX), which has proved to be effective. OBJECTIVES: The aim of this randomized double-blind clinical trial was to evaluate the efficacy of 0.2% bioadhesive chlorhexidine gel placed intra-alveolar in the prevention of AO after the extraction of mandibular third molars and to analyze the impact of risk factors such as smoking and oral contraceptives in the development of AO. STUDY DESIGN: The study was a randomized, double-blind, clinical trial performed in the Ambulatory Surgery Unit of Hospital Vall d'Hebron and was approved by the Ethics Committee. A total of 160 patients randomly received 0.2% bioadhesive gel (80 patients) or bioadhesive placebo (80 patients). RESULTS: 0.2% bioadhesive chlorhexidine gel applied in the alveolus after third molar extraction reduced the incidence of dry socket by 22% compared to placebo with differences that were not statistically significant. Smoking and the use of oral contraceptives were not related to higher incidence of dry socket. Female patients and the difficulty of the surgery were associated with a higher incidence of AO with statistically significant differences. 0.2% bioadhesive chlorhexidine gel did not produce any of the side effects related to chlorhexidine rinses. CONCLUSIONS: A 22% reduction of the incidence of alveolar osteitis with the application of 0.2% bioadhesive chlorhexidine gel compared to placebo with differences that were not statistically significant was found in this clinical trial. The lack of adverse reactions and complications related to chlorhexidine gel supports its clinical use specially in simple extractions and adds some advantages compared to the rinses in terms of duration of the treatment and reduction of staining and taste disturbance.

Submaxillary gland mucocele: presentation of a case.

The term mucocele is referred to two concepts: the extravasation cysts resulting from salivary glandular duct rupture, with mucin leakage into the surrounding peri-glandular soft tissue, and the retention cysts, caused by a glandular duct obstruction and resulting in a decrease or even an absence of glandular secretion. Mucocele can not be considered as a true cyst because its wall lacks an epithelial lining. These lesions are very common in the minor salivary glands (particularly in the labial glands), but are very infrequent in the major salivary glands--including the submaxillary glands. The present study describes a clinical case of a right submaxillary gland mucocele resolved by surgical treatment and reviews the differential diagnosis with other clinical entities.

Polymorphous low-grade adenocarcinoma of the nasal fossa.

An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient.

Effect of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on the incidence of alveolar osteitis following the extraction of mandibular third molars. A double-blind randomized clinical trial

Alveolar osteitis (AO) is a common complication after third molar surgery. One of the most studied agents in its prevention is chlorhexidine (CHX), which has proved to be effective. OBJECTIVES: The aim of this randomized double-blind clinical trial was to evaluate the efficacy of 0.2% bioadhesive chlorhexidine gel placed intra-alveolar in the prevention of AO after the extraction of mandibular third molars and to analyze the impact of risk factors such as smoking and oral contraceptives in the development of AO. Study DESIGN: The study was a randomized, double-blind, clinical trial performed in the Ambulatory Surgery Unit of Hospital Vall d'Hebron and was approved by the Ethics Committee. A total of 160 patients randomly received0.2% bioadhesive gel (80 patients) or bioadhesive placebo (80 patients).RESULTS: 0.2% bioadhesive chlorhexidine gel applied in the alveolus after third molar extraction reduced the incidence of dry socket by 22% compared to placebo with differences that were not statistically significant. Smoking and the use of oral contraceptives were not related to higher incidence of dry socket. Female patients and the difficulty of the surgery were associated with a higher incidence of AO with statistically significant differences.0.2% bioadhesive chlorhexidine gel did not produce any of the side effects related to chlorhexidine rinses. CONCLUSIONS: A 22% reduction of the incidence of alveolar osteitis with the application of 0.2% bioadhesive chlorhexidinegel compared to placebo with differences that were not statistically significant was found in this clinical trial. The lack of adverse reactions and complications related to chlorhexidine gel supports its clinical use specially in simple extractions and adds some advantages compared to the rinses in terms of duration of the treatment and reduction of staining and taste disturbance

Calvarial bone harvesting with piezoelectric device.

We introduce the use of a piezoelectric device in order to harvest calvarial bone grafts. The vibration frequency of the instrument allows for the efficient cutting of bone without the risk of accidentally damaging the dura.

Aggressive glomus tumor of the tongue: report of a case.

A glomus tumor or glomangioma is a benign neoplasm originating from the modified smooth muscle cells of the vascular glomus Glomangiomas of the head and/or neck are extremely rare, with an incidence of 0.6%. We present an observational case report of a recurrent glomic tumor originally located in the mobile tongue, with an aggressive clinical course that complicated the therapeutic options of the case.

Mucocele de la glandula submaxilar: a propósito de un caso / Submaxillary gland mucocele: presentation of a case

El mucocele es un término que incluye dos conceptos: el quiste de extravasación, que resulta de la ruptura del conducto de la glándula salival y el consiguiente derrame de la mucina en los tejidos blandos que rodean a dicha glándula, y el quiste de retención, que tiene su origen en la disminución o ausencia de la secreción glandular como consecuencia de la obstrucción del conducto de la glándula salival. No se puede considerar al mucocele como un verdadero quiste, ya que su pared carece de revestimiento epitelial. Este tipo de patología es muy común en las glándulas salivales menores (sobretodo en las labiales), pero es muy poco frecuente en las glándulas salivales mayores y en concreto, en la glándula submaxilar. El presente trabajo expone el caso clínico de un mucocele de glándula submaxilar derecha, resuelto mediante tratamiento quirúrgico y revisa todas aquellas entidades con las que se de-be establecer el diagnóstico diferencial

The term mucocele is referred to two concepts: the extravasation cysts resulting from salivary glandular duct rupture, with mucin leakage into the surrounding peri - glandular soft tissue, and the retention cysts, caused by a glandular duct obstruction and resulting in a decrease or even an absence of glandular secretion.Mucocele can not be considered as a true cyst because its wall lacks an epithelial lining.These lesions are very common in the minor salivary glands (particularly in the labial glands), but are very infrequent in the major salivary glands - including the submaxillary glands.The present study describes a clinical case of a right submaxillary gland mucocele resolved by surgical treatment and reviews the differential diagnosis with other clinical entities

Adenocarcinoma Polimorfo de Bajo Grado de fosa nasal / Polymorphous low-grade adenocarcinoma of the nasal fossa

Se presenta un inusual caso de Adenocarcinoma Polimorfo de Bajo Grado en estadio IV (T4N2CMx) localizado en la fosa nasal con extensión hacia región pterigoidea. El tumor primario fue tratado mediante una resección del mismo a través una osteotomía de maxilar superior tipo Lefort I y a nivel cervical se realizó un vaciamiento ganglionar cervical supraomohioideo homolateral. Posteriormente recibió tratamiento coadyuvante con radioterapia postoperatoria

An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient

Caso clínico: Tumor glómico agresivo de localización lingual / Aggressive glomus tumor of the tongue: Report of a case

El tumor glómico es una neoplasia benigna que se origina en las células musculares lisas del glomus vascular. Los glomagiomas de cabeza y cuello son raros, con una incidencia del 0,6%. Presentamos un caso clínico de tumor glómico recidivante, localizado originalmente en la lengua, con un comportamiento clínico agresivo que complicó las opciones terapeuticas del caso (AU)

A glomus tumor or glomangioma is a benign neoplasm originating from the modified smooth muscle cells of the vascular glomus Glomangiomas of the head and/or neck are extremely rare, with an incidence of 0.6%. We present an observational case report of a recurrent glomic tumor originally located in the mobile tongue , with an aggressive clinical course that complicated the therapeutic options of the case (AU)

Expansión rápida de paladar asistida quirúrgicamente / Surgically assisted rapid palatal expansion

La expansión rápida de paladar asistida quirúrgicamente es una técnica de cirugía mayor ambulatoria que permite corregir de forma segura y efectiva trastornos transversales del maxilar superior. Se presenta la experiencia de los autores con la variante técnica consistente en una corticotomía de la pared lateral del maxilar superior combinada con una osteotomía palatina media efectuada por vía interincisal. Se presenta además una revisión de otras opciones operatorias, de los resultados sobre la estabilidad y de las eventuales complicaciones de la misma. (AU)

Amiloidosis primaria con afectación lingual masiva / Primary amyloidosis with severe macroglossia

La amiloidosis primaria es una enfermedad sistémica caracterizada por el depósito extracelular de amiloide. El diagnóstico de la amiloidosis se basa en la sospecha clínica y la confirmación por biopsia de tejido.El pronóstico de la amiloidosis está ligado a la afectación orgánica. La infiltración amiloide de los diversos tejidos y organos provoca la alteración de las células parenquimatosas y la dysfunctón de los órganos afectos. La macroglosia es característica, aunque no exclusiva, de la amiloidosis primaria, y como sintomatología puede producir alteraciones del habla, disgeusia y disfagia, por lo que algunos pacientes podrían beneficiarse de una glosectomía reductora. Se han descrito diferentes técnicas quirúrgicas con el objetivo de disminuir el volumen lingual, intentando a su vez mantener la funcionalidad y estética de la lengua. Presentamos un caso clínico de afectación lingual masiva por amiloidosis primaria, y se discuten las indicaciones, las diferentes técnicas quirúrgicas y una revisión de la literatura (AU)