Mandibular Body Reconstruction Utilizing a Three-Dimensional Custom-Made Porous Titanium Plate: A Four-Year Follow-Up Clinical Report.

A clinical case of a 42-year-old woman patient, who had a mandibular reconstruction utilizing a three-dimensional (3D) custom-made porous titanium plate dental restoration, is presented. She showed a recurrence of a unicystic ameloblastoma involving the left hemimandible. The patient declined to be managed by a bone-free flap. A mandibular resection in the healthy areas was provided, followed by reconstruction utilizing a 3D custom-made porous titanium plate dental restoration with a hybrid dental prosthesis. The 3D rehabilitation was created considering slim tomodensitometric sections. The cutting guides and custom-created 3D plate were fabricated employing medical software via computer-aided design and fabricating with locations planned for healing abutments. The patient was contented with the rehabilitation, and the condition continued stable at the four-year follow-up.

Relationship of the XRCC1 rs25487 polymorphism with demographic, behavioral, clinical, and histological parameters in oral potentially malignant disorders and oral squamous cell carcinoma in a Colombian population.

OBJECTIVES: To evaluate the salivary detection of XRCC1 rs25487 single-nucleotide polymorphism (SNP), its relationship with clinicopathological characteristics, and the interactions with demographic/behavioral variables in the etiopathogenesis of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) in a Colombian population. METHODS: Demographic/behavioral data and saliva samples were obtained from patients with oral leukoplakia (OL, n = 17) and oral lichenoid lesions with epithelial dysplasia (OLL-ED, n = 10), or OSCC (n = 45), along with healthy controls (n = 40). Tissue biopsies were obtained for histological assessment and genetic analysis was performed using polymerase chain reaction-restriction fragment length polymorphism. Descriptive analyses were used to compare the distribution of genotypes/alleles between study groups alongside an analysis of the interaction between genetic findings and demographic/behavioral variables. RESULTS: No association was observed between the genotype and allele frequencies in OPMD or OSCC. The AG genotype was significantly more frequent in OL with high-grade dysplasia, acanthotic epithelial lining, moderate-to-severe mitotic count, and negative-to-mild apoptotic count; and in OSCC cases with stage III/IV, poorly differentiated, perineural/lymphovascular invasion, severe cellular atypia, moderate-to-severe mitotic count, and negative-to-mild apoptotic counts. Significant interaction effects were detected in the AG genotype with regard to ageing, smoking habits, and alcohol consumption in both OL and OSCC. CONCLUSION: Although rs25487 SNP appeared to not modulate the risk of OPMD/OSCC independently, its significant association with clinicopathological characteristics in OL and OSCC, and the synergistic interaction between ageing and smoking/alcohol consumption, might play a role in these two diseases.

Diagnosis and treatment for central Mucoepidermoid Carcinoma in the mandible: Report of a clinical case in a young patient.

A clinical case of a 13 year old male patient with a malignant tumor in the mandibular body area with two years of evolution and associated pain is reported. It was initially diagnosed as low grade central mucoepidermoid carcinoma through Hematoxylin and Eosin (H-E) staining in multiple biopsies. Considering the clinical and radiographic characteristics of the lesion, it was necessary to confirm the diagnosis through Periodic acid-Schiff (PAS). The treatment involved hemimandibulectomy, neck emptying, and complementary radiotherapy. This article aims to present a rare occurrence of this type of intraosseous malignant tumor of glandular origin in a young patient. Key words:Mucoepidermoid carcinoma, periodic acid Schiff reaction, pathology, surgery, radiotherapy.

Painless osteoid osteoma in the maxilla of an elderly female patient.

Osteoid osteoma is an osteoblastic benign bone tumor more frequent in long bones of young male patients. It is the third most commonly diagnosed benign bone tumor and has distinctive symptomatology, nocturnal pain that relieves with nonsteroidal anti-inflammatory drugs. Nowadays, total resection is the preferred management. In the present paper, an unusual variant in the maxilla of a female elderly patient without previous symptomatology is exposed; it was surgically removed without signs of reappearance in 12 months of follow-up. Although it is not a common site of appearance, the manifestation of this tumor in the skull bones seems to be associated with a different pattern in contrast to the skeletal type as can be seen in the present case and others previously reported. The authors consider due to the clinical similarity between this and other tumors that it should be taken into consideration for future diagnosis dilemma.

Manifestaciones craneofaciales en pacientes con osteodistrofia renal / Craneofacial manifestaciones in patients with renal osteodystrophy

Introducción: La osteodistrofia renal es una osteopatía metabólica difusa, relacionada con la insuficiencia renal crónica, que incluye diversas patologías en el sistema musculoesquelético. Se produce en respuesta a trastornos metabólicos generados por cambios electrolíticos, la inflamación crónica y la alteración hormonal. Estas variaciones modifican el proceso de remodelación ósea. Las manifestaciones clínicas incluyen alteración en el parénquima y estroma óseo, y van desde lesiones expansivas, produciendo deformidad, hasta fracturas patológicas del hueso. Objetivo: Relacionar las manifestaciones clínicas, imagenológicas e histológicas en el componente óseo cráneo facial para el diagnóstico de la osteodistrofia renal. Presentación de caso: Se presentan dos casos clínicos de pacientes con enfermedad renal crónica e hiperparatiroidismo secundario de base, con múltiples masas en maxilares que causan asimetría facial y alteración funcional. Las imágenes tomográficas revelan alteración en la morfología ósea cortical y trabecular. Ambos individuos evidenciaron alteraciones en niveles de hormona paratiroidea, fosfatasa alcalina, fósforo y calcio sérico. La histopatología comprobó tejido fibroóseo con hueso neoformado y gran vascularización, con células multinucleadas tipo osteoclastos sin presencia de hemosiderina. Pacientes manejados de forma interdisciplinaria entre medicina interna, endocrinología y cirugía maxilofacial. Conclusiones: Los pacientes con enfermedad renal crónica avanzada presentan alteración de la estructura y del metabolismo óseo y mineral. Tal situación puede comprometer el complejo óseo craneofacial. Los casos graves de osteodistrofia renal se caracterizan por una marcada expansión de los maxilares, que genera asimetría y rasgos de leontiasis. Las imágenes tomográficas asociadas a osteodistrofia renal presentan óseos trabeculares con expansión de cortical, que evidencia el recambio óseo inmaduro presente. La histopatología no es específica y puede ser similar a los casos de displasia ósea craneofacial. Ante lo anteriormente planteado es fundamental relacionar estos hallazgos con la clínica para definir un diagnóstico adecuado(AU)

(AU)Introduction: Renal osteodystrophy is a diffuse metabolic osteopathy, related to chronic renal failure, which includes various pathologies in the musculoskeletal system. It occurs in response to metabolic disorders generated by electrolyte changes, chronic inflammation and hormonal alteration. These variations modify the process of bone remodeling. Clinical manifestations include alteration in the parenchyma and bone stroma, and range from expansive lesions, producing deformity, to pathological fractures of the bone. Objective: Relate the clinical, imaging and histological manifestations in the skull-facial bone component for the diagnosis of renal osteodystrophy. Case Presentation: Two clinical cases of patients with chronic kidney disease and secondary underlying hyperparathyroidism are presented, with multiple masses in the jaws that cause facial asymmetry and functional alteration. Tomographic images reveal alteration in cortical and trabecular bone morphology. Both individuals showed alterations in levels of parathyroid hormone, alkaline phosphatase, phosphorus and serum calcium. Histopathology verified fibro-bone tissue with neoformed bone and great vascularization, with multinucleated osteoclast-like cells without the presence of hemosiderin. Patients were attended in an interdisciplinary way between internal medicine, endocrinology and maxillofacial surgery. Conclusions: Patients with advanced chronic kidney disease present alteration of the structure and bone and mineral metabolism. Such a situation can compromise the craniofacial bone complex. Severe cases of renal osteodystrophy are characterized by a marked expansion of the jaws, which generates asymmetry and traits of leonthiasis. The tomographic images associated with renal osteodystrophy present trabecular bones with cortical expansion, which evidences the immature bone turnover present. Histopathology is not specific and may be similar to cases of craniofacial bone dysplasia. Given the above, it is essential to relate these findings to the clinic to define an adequate diagnosis(AU)

Concordancia inter-examinador en la evaluación de hallazgos periodontales mediante radiografías panorámicas / Inter-examiner concordance in the assessment of periodontal findings by means of panoramic X-rays

RESUMEN Objetivo Estimar el grado de concordancia inter-examinador en la interpretación de hallazgos periodontales en radiografías panorámicas en estudiantes de último año de la Facultad de Odontología de la Universidad de Cartagena. Material y métodos Se realizó un estudio descriptivo de concordancia-consistencia inter-observador para la interpretación de hallazgos periodontales en radiografías panorámicas entre estudiantes de último año de pregrado de la Facultad de Odontología de la Universidad de Cartagena, con relación a un especialista en periodoncia. La evaluación de la concordancia se realizó a través del coeficiente kappa utilizando SPSS Statistics 2.0. Resultados Se evaluaron a 80 estudiantes del último año de pregrado. Cada uno valoró dos radiografías panorámicas, para un total de 160 observaciones. La concordancia general estableció un valor de kappa mínimo de 0.011 y un valor máximo de 0.720. Conclusiones La concordancia entre los estudiantes observadores y el estándar de oro fue pobre. Lo que indica que los estudiantes no aplican los conocimientos obtenidos durante el pregrado de odontología, dando así una errónea impresión del estado periodonto.

ABSTRACT Objective To assess the degree of inter-examiner concordance in the interpretation of periodontal findings in panoramic X-rays in last year students of the School of Dentistry at the University of Colombia. Material and methods A descriptive inter-observer concordance-consistency study was conducted for interpretation of periodontal findings in panoramic X-rays among last year students of the School of Dentistry of the University of Colombia and compared results to thos obtained by a periodontics specialist. Concordance evaluation was achieved by means of a kappa coefficient using SPSS Statistics 2.0 program. Results 80 last year students (undergraduate seniors) were evaluated each one assessed two panoramic X-rays, for a total of 160 observations. General concordance established a minimum kappa value of 0.011, and maximum value of 0.720. Conclusions Concordance among observing students and the gold standard was poor. This indicated that students did not apply acquired knowledge during their undergraduate dental studies, and provided thus a misleading impression on the circumstances of the periodontium.