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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E158.

Letter to the Editor: Burning mouth syndrome and risk of allergy.

Pigatto PD, Spadari F, Guzzi G.

Via A. Banfi, 4, 20122 Milan – Italy, gianpaolo_guzzi@fastwebnet.it.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E159-E162.

A treatment for oral precancerous lesions: Why do we not yet have a treatment?

Lozada-Nur F.

University of California, San Francisco, USA, francina.nur@gmail.com.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E163-E166.

Chronic maxillary sinusitis associated with dental impression material.

Rodrigues MT, Munhoz EA, Cardoso CL, Freitas CA, Damante JH.

Department of Oral Medicine, Bauru School of Dentistry - University of São Paulo, Al. Dr. Otávio Pinheiro Brisolla 9-75 17.012-901, Bauru – São Paulo – Brasil, etiamfob@yahoo.com.

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E167-E170.

Primary extracranial meningioma of the mandible.

Mosqueda-Taylor A, Domínguez-Malagon H, Cano-Valdez AM, Montiel-Hernandez AM.

Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, México, D.F. 04960, mosqueda@correo.xoc.uam.mx.

Meningiomas are benign tumors of mesodermal origin that arise from arachnoid cell clusters that penetrate the dura to form arachnoid villi. These neoplasms represent one of the most common neoplasms developing within the central nervous system and are usually located at points of entry of vessels and nerves through the dura. Extracranial meningiomas (EM) comprise only 2% of all meningiomas, and only six cases of primary EM of the jawbones have been described to date. They may arise as an extension of intracranial meningiomas or as primary tumors and may be clinically indistinguishable from other benign tumours of the jaws, as they usually present as a well-delineated unencapsulated tumors. In this article a case of primary intramandibular primary EM that appeared as a well-defined osteolytic radiolucent lesion of the jaw is reported. The salient clinico-pathological features of this case is compared to those previously reported in the literature and differential diagnosis and therapeutic considerations are discussed.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E171-E174.

Squamous cell carcinoma arising from an odontogenic keratocyst: A case report.

Falaki F, Delavarian Z, Salehinejad J, Saghafi S.

Department of Oral Medicine, Faculty of Dentistry and Dental Research Center, Mashhad, P.O.Box:91735-984, Iran, falakif@mums.ac.ir.

Squamous cell carcinoma (SCC) derived from keratocystic odontogenic tumor is an extremely rare tumor that is limited to the jaws. Most intraosseous carcinomas originate from the epithelial lining of odontogenic cysts, so they are called odontogenic carcinomas. They occur more frequently in men and the mean age of patients is 57 years. The following report describes an extremely rare case of an odontogenic carcinoma derived from a keratocystic odontogenic tumor in a 20-year-old man. The patient presented with an exophytic lesion in the retromolar region of the mandible which was first noticed by the patient 25 days earlier. In panoramic radiograph a well-defined radiolucency around the impacted 3rd molar was observed. Clinical and radiographic diagnosis was odontogenic SCC. Surgical resection was performed and histhopathologic examination of the lesion confirmed the diagnosis of SCC in the wall of a keratocystic odontogenic tumor.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E175-E179.

Type 1 diabetes mellitus and periodontal disease: Relationship to different clinical variables.

Silvestre FJ, Miralles L, Llambes F, Bautista D, Solá-Izquierdo E, Hernández-Mijares A.

Sección de Pacientes Especiales, Clínica Odontológica Universitaria (Universidad de Valencia), C/ Gascó Oliag n 1, 46010-Valencia, Spain, francisco.silvestre@uv.es.

Objective: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications. Methods: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications. Results: Diabetics had greater bleeding index (p< 0.01), deeper periodontal pockets (p< 0.01) and more periodontal attachment loss (p< 0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p</= 0.02). Conclusions: Patients with type 1 diabetes appear to show increased periodontal disease susceptibility, particularly those with poorer metabolic control or with diabetic complications.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E180-E182.

Cervical tularaemia in a non-endemic area.

Gallego L, Junquera L, Palacios JJ, de Vicente JC.

School of Dentistry, University of Oviedo, Catedrático José Serrano s/n, 33009 Oviedo. Spain, Junquera@uniovi.es.

Tularemia is a zoonotic disease caused by Francisella tularensis. The microorganism is transmitted to humans by contact with, or ingestion of, infected animal tissues, by insect bites, consumption of contaminated food or water, or from inhalation of aerolized bacteria. In this report we describe a case of tularemia presenting with multiple cervical lymphadenitis in Asturias (Spain). Final diagnosis was established based on a serological test. The patient was successfully managed with surgery and streptomycin for 2 weeks. The ulceroglandular form of tularemia should be considered in the differential diagnosis of cervical lymphadenitis, particularly in those not responding to penicillin treatment. To our knowledge, this is the first case described in Asturias, a north coast county of Spain.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E183-E187.

Observational study of 67 wide platform implants treated with avantblast surface. Results at three year.

Barona-Dorado C, Martínez-Rodríguez N, Torres-Lear F, Martínez-González JM.

Universidad Complutense de Madrid, Cirugía Bucal, Madrid, Spain, crisbarona@hotmail.com.

Objective: This paper shows the results of the clinical and radiographic behavior, at 3 years, of 67 wide platform implants undergoing prosthetic load. Study Design: This is an observational prospective study of 67 implants in 49 patients within the range of 54-69 years of age. Screening was performed after a radiological study with panoramic and tomographic radiographs followed by the implantological treatment with prosthetic load and clinical (15 days, 1, 6, 12, 24 and 36 months) and radiological control follow-up (6, 12, 24 and 36 months). Results: During the healing period 1 implant failed, representing a 98.5% survival. After placing the prosthesis, it was not necessary to remove any implant, therefore 66 implants remain successfully in place. Conclusions: The favorable results and follow-up after the prosthetic load of 66 implants (CSR of 100%) attest that wide platform implants can and should be applied after careful planning and case selection.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E188-E193.

Risk of temporomandibular joint effusion related to magnetic resonance imaging signs of disc displacement.

Orlando B, Chiappe G, Landi N, Bosco M.

Via Nuova Italia 75/1, 16033 Lavagna (GE), Italy, giacomochiappe@hotmail.it.

Background: It has been suggested that TMJ effusion may represent an inflammatory response to a dysfunctional disc-condyle relationship. The purpose of the present study was to evaluate whether the status of the disc in the temporomandibular joint, as depicted in magnetic resonance (MR) images, is predictive of the presence of temporomandibular joint (TMJ) effusion. Methods: The relationship between disc displacement and TMJ effusion was analyzed in MR images of 154 TMJs in 77 patients complaining for pain and/or dysfunction in the TMJ area and referred from medical practitioners to specialist consultation. Logistic regression analysis was used to identify the significant correlation between presence/absence of joint effusion and disc displacement. Results: Significant correlation (P<0.01) between disc displacement and joint effusion was found. OR for all type of disc displacement was 3.1, and the odds that a joint had magnetic resonance imaging findings of effusion was greater for anterior disc displacement without reduction. Conclusions: The status of the disc could represent a factor involved in the development of temporomandibular joint oedema. However, these findings suggest that disc displacement may not be regarded as the dominant factor in defining the occurrence of TMJ effusion. Certain local or systemic conditions other than the disc-condyle relationship must be considered.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E194-E197.

Osteochondroma of the mandibular condyle: Resection and reconstruction using vertical sliding osteotomy of the mandibular ramus.

González-Otero S, Navarro-Cuéllar C, Escrig-de Teigeiro M, Fernández-Alba-Luengo J, Navarro-Vila C.

Servicio de Cirugía Maxilofacial Hospital General Universitario Gregorio Marañón, C/ Doctor Esquerdo 46, 28007 Madrid, Spain, drsgonzalez@gmail.com.

Osteochondroma is one of the most common benign bone tumours, although not in the craniofacial region. More than half of these appear in the coronoid process. It can appear on the mandibular condyle, especially in its medial half, and mainly affects women aged around forty years. We present the case of a 51-year-old woman with pain of several months' duration in the right temporomandibular joint (TMJ) and no other symptoms. Panoramic radiography showed an enlarged condyle with no subchondral cysts. Computed tomography showed a bony proliferation with benign signs and a scintigraphy revealed an increased uptake in the condyle. Due to the painful clinical symptoms, a surgical procedure using preauricular and retromandibular approaches was performed to excise the condyle. The resulting defect, which was 9 mm high, was reconstructed by means of a vertical sliding osteotomy of the mandibular ramus and two miniplates for osteosynthesis. Almost two years later, the patient is symptom-free and has a normal opening with no malocclusion or deviation in the opening pattern. We present and discuss different reconstruction options after condylectomy.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E198-E202.

Transalveolar screw: A new concept for orthodontic anchorage.

Hernández-Alfaro F, Egio E, Ruiz V.

Instituto de Cirugía Maxilofacial e Implantología Centro Medico Teknon, C/ Vilana, 12, 08022, Barcelona, Spain, director@institutomaxilofacial.com.

The purpose of this article is to describe the use of a new trans-alveolar screw (TAS) as a temporary orthodontic anchorage device for the posterior maxilla, to intrude overerupted maxillary molars. To date, five consecutive patients have been treated with these newly designed screws. Intrusions achieved ranged from 2.1 and 6mm (mean 4.7mm). The TAS is cheap, easy to place and remove by the orthodontist, has bicortical anchorage, and is loaded on both sides. The main advantage of TAS is that when placed in the maxilla to intrude upper molars, it allows application of intrusive force from both buccal and palatal aspects simultaneously, so that the line of force in relation to the center of resistance of the posterior segment, permits an in-mass intrusion, avoiding buccal tipping or rotations. Moreover the surgical procedure for inserting and removing the bicortical screw is simple and does not require any surgical flap, so complications are minimal and screws can be loaded immediately, without requiring any waiting healing period of time.

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Med Oral Patol Oral Cir Bucal. 2009 Apr 1;14(4):E203-E209.

Bone resorption processes in patients wearing overdentures. A 6-years retrospective study.

López-Roldán A, Santolaya-Abad D, Gregori-Bertomeu I, Gómez-Castillo E, Selva-Otaolaurruch E.

C/ Abat Guillem de Agulló 14, Quart de Poblet, Valencia 46930, Spain, anndylopez@hotmail.com.

Objectives: 1. - To measure the alveolar resorption processes that occur in patients wearing mandibular overdentures on 2 implants and fully-removable maxillary dentures, and to evaluate the same process on patients wearing fully-removable dentures on both arches. 2.- To verify whether Kelly's Combination Syndrome occurs in the group of patients wearing overdentures. Method and Material: Forty patients were evaluated, of which a "cases" group was formed by 25 patients wearing mandibular overdentures on 2 lower jaw implants and fully-removable dentures on the opposite arch. The other 15 patients formed a control group that wore fully-removable dentures on both arches. Each one of the patients underwent orthopantograms from the moment the dentures were inserted until an average of 6 years later, which were assessed based on the Xie et al. method to estimate vertical bone loss. Once the data was collected, it was subjected to statistical analysis. Results: In terms of the maxillary midline, we observed a greater loss in patients wearing overdentures, which was statistically significant, as it registered 0.32 mm/year. Mandibular bone loss was 2.5 times less in patients in the cases group. The rest of the clinical criteria for Kelly's Combination Syndrome were not observed. Conclusions: Kelly's Combination Syndrome did not occur in the patients in the cases group. In spite of the greater bone loss on a premaxillary level in this group, the placing of the overdenture on the implants significantly reduced mandibular bone resorption.