Asunto(s)
Querubismo/complicaciones , Querubismo/patología , Anomalías Maxilomandibulares/etiología , Mandíbula/anomalías , Niño , Femenino , Granuloma de Células Gigantes/etiología , Humanos , Anomalías Maxilomandibulares/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Three cases of cherubism belonging to the same genealogical tree which had been followed up since the age of 7 years to adulthood are presented. These cases prove that, without treatment, the regression of the lesions and bone regeneration are real and not anecdotal. Nevertheless, following spontaneous bone regeneration, radiographically some radiolucent areas of low intensity and devoid of trabeculations, and/or areas of sclerotic bone do persist. In one case, cherubism was associated with peripheral giant cell granulomas localized in areas not affected by cherubism.
Asunto(s)
Regeneración Ósea , Querubismo/genética , Adulto , Querubismo/patología , Querubismo/fisiopatología , Niño , Femenino , Estudios de Seguimiento , Granuloma de Células Gigantes/genética , Granuloma de Células Gigantes/patología , Humanos , Masculino , Enfermedades Mandibulares/genética , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/fisiopatología , Osteosclerosis/genética , Osteosclerosis/patología , Remisión EspontáneaRESUMEN
Five out of 4,172 operated maxillary cysts (3 developed within the maxillary and 2 in the mandible) presented a malignant change of epithelium. In all these 5 cases histology demonstrated a transition from normal to cancerous epithelium. The overall percentage of malignant change was of 0.12%, with 0.077% for non-keratinized epithelium lining odontogenic cysts (3 cases) and 0.65%, that is 8 times higher, for keratinized ones (2 cases). Keratinization of cystic epithelium and chronic inflammatory lesions were the main risk factors.
Asunto(s)
Carcinoma de Células Escamosas/patología , Transformación Celular Neoplásica/patología , Enfermedades Mandibulares/patología , Neoplasias Mandibulares/patología , Enfermedades Maxilares/patología , Neoplasias Maxilares/patología , Quistes Odontogénicos/patología , Adulto , Anciano , Quiste Epidérmico/patología , Epitelio/patología , Femenino , Humanos , Queratinas , Masculino , Persona de Mediana Edad , Quiste Radicular/patologíaRESUMEN
After a delay of 7 to 21 years, bilateral parotidectomy with complete preservation of the facial nerves and myoplasty of the post-operative cavities for enlarged parotid glands due to Sjögren's syndrome was found to have been beneficial in 10 patients. Excellent results were obtained both in terms of aesthetic and psychic outcome, but also in terms of greatly improved general health. Patients' psychoaffective, familial, professional and social lifestyle had returned to normal.
Asunto(s)
Glándula Parótida/cirugía , Síndrome de Sjögren/cirugía , Adulto , Estética , Cara , Nervio Facial/fisiología , Femenino , Estudios de Seguimiento , Humanos , Hipertrofia , Persona de Mediana Edad , Músculos/trasplante , Glándula Parótida/inervación , Glándula Parótida/patología , Síndrome de Sjögren/tratamiento farmacológico , Síndrome de Sjögren/psicologíaRESUMEN
In 6 cases of tumors, two gigantic benign and four malignant in T4 having palatal and gingivo-alveolar starting point with invasive evolution into the structure of facial mass, surpassing the median alignment, the authors consider the problem concerning the indications for exeresis, possibilities of removal of healthy tissue and the reconstruction of massive losses of substance. The surgical treatment of reconstruction that completes the exeresis of the tumor is meant to sustain the ocular globe through a aponeurotic-muscular flap form the temporal muscle, with the aid of nasal septum or a skin graft also used to obtain a good coating of the cavity, and is also meant to a plastic reconstruction of the soft palate as well as to retention modelling of the cavity fields which resulted postsurgically. The main role in maxillofacial reconstruction in held by the obturator prosthesis that avoids morphofunctional prejudices and restores facial contour, without aesthetic and psychic prejudices. The results obtained in our 6 cases shown here have been fully satisfactory.
Asunto(s)
Maxilar/cirugía , Prótesis Maxilofacial , Obturadores Palatinos , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Humanos , Masculino , Neoplasias Maxilares/cirugía , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Neoplasias de Células Germinales y Embrionarias/cirugíaRESUMEN
New diversified plastic surgery methods have been introduced into practice in the last decades, aimed at repairing the loss of facial tissues involving the upper lip (with or without co-involvement of the lateral parts of the nose), and the lower eyelid area, that cannot be repaired by flaps prepared in the surrounding regions. In view of avoiding the disadvantages of 2- or 3-stage techniques the authors have re-evaluated the method introduced by Esser in 1918 for plastic repair of the facial tissues by rotation of the cheek, which is economical, efficient, rapid, and elegant, providing fully satisfactory esthetic results. Two cases are presented, one with loss of facial tissue following removal of an achromic recidivating melanoma, and another one following removal of a recidivating baso-cellular carcinoma, in which this method was employed with excellent results.
Asunto(s)
Carcinoma Basocelular/rehabilitación , Neoplasias Faciales/rehabilitación , Melanoma/rehabilitación , Cirugía Plástica , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Colgajos QuirúrgicosRESUMEN
Five cases are presented, of suppurated cervico-mediastinitis developed after acute suppurated apical parodontitis of a lower molar tooth. In two cases the severity and the extension of the lesions resulted in a fatal outcome. In one of the cases the patient also had pericarditis, pleurisy and purulent meningitis, and in the second case the necrotizing mediastinitis extended to the pleural and pericardic cavities, and was associated to bilateral bronchopneumonia. In three cases the patients were cured following cervical mediastinotomy, efficient mediastinal aspiration of the anterior and of the posterior mediastinum, in association with antiinfectious and resuscitation therapy. Since the prognosis of these major complications is still severe the risk of diffusion of odontogenic suppurations should not be ignored or minimized since in all the cases iatrogenic factors have occurred over the evolution of the patients. Knowledge of stomatologists should be improved and they should be aware of the risks of odontogenic suppuration involving parapharyngeal and cranio-encephalic extension, or the risk of cervico-mediastinal diffusion.
Asunto(s)
Infección Focal Dental , Mediastinitis/etiología , Periodontitis Periapical/complicaciones , Adulto , Femenino , Humanos , Masculino , Mediastinoscopía , Meningitis , Persona de Mediana EdadRESUMEN
The prophylactic orientation is a basic principle, the application of which, in the stomatological practice, on a constant basis, aims at a significant improvement in the status of bucco-dental health of the population, and the transformation of the present type of stomatology, in a truly modern stomatological medicine. The author makes a detailed analysis of the strategy employed in the reduction of the provence of the main bucco dental diseases, and of the necessities for stomatological treatment, especially of the reduction by over 50% of the prevalence of dental caries, which, at the present time, makes necessary to carry out approximately 75% of the entire volume of stomatologic activities in adults. Also the reduction is attempted, of the prevalence of gingivitis, parodontitis, dento-maxillary anomalies, of the cancer of the buccal cavity, and other affections, by methods and means of primary prophylaxis, applied in the majority of the population. The secondary prophylaxis is also analysed, as it is carried out by early detection and treatment of lesions and diseases in the dento-maxillo-facial field. Other aspects are also discussed, such as: extension of the prophylactic orientation in the curative stomatological practice, and the avoidance of iatrogenic lesions and diseases, which are frequent in the stomatological practice; the ergonomic organization of the working place, and of the work methods, reduction of the risks involved in contracting or transmitting to or from the patients of various diseases, prophylaxis of occupational diseases in stomatologists, prophylaxis of aspects, attitudes or behaviour which are against etichal and deontological principles of the profession, as well as the necessity for a better preparation from the prophylactic viewpoint of stomatologists and their coworkers in view of coping with increased competence and efficiency with the increased demands of stomatological assistance of the population.