Langerhans cell histiocytosis: current concepts in dentistry and case report

Langerhans cell histiocytosis (LCH), which is a rare granulomatous pediatric disease of unknown etiology, is characterized by the idiopathic proliferation and accumulation of abnormal and clonal Langerhans cells or their marrow precursors, resulting in localized, solitary or multiple destructive lesions. These lesions are most commonly eosinophilic granuloma, which are found in craniofacial bone structures such as the skull and mandible, skin and other organs. In children, the disease has a variable initial presentation, and the clinical course, prognosis and survival are unpredictable. The aims of this report were to present an LCH case in a girl aged 2 years, 8 months and her clinicopathological features, to describe the bucodental management provided, and to discuss special dental considerations of this diseas

Adenoma Pleomorfo en Glándulas salivales menores. Reporte de una Serie de casos

  Pleomorphic adenoma (PA) is the most common benign tumor of the salivary glands that is characterized by its broad pleomorphic architecture. It represents 53-77% of all salivary gland neoplasms, mainly affecting the major salivary glands; however the minor salivary glands is an infrequent site of occurrence, representing 5-10% of cases, mainly on the palate and lip, nasal cavity, pharynx, larynx and trachea. The confirmatory diagnosis is performed with a histopathological study. The indicated treatment is the wide resection of the tumor. It is essential to know the surgical technique to avoid the recurrence of the disorder. Therefore, the aim of the present paper is to describe three  cases of PA located in infrequent sites of PA, such as the minor salivary glands.  El adenoma pleomórfico (AP) es el tumor benigno más común de las glándulas salivales, el cual es caracterizado por su amplia arquitectura pleomórfica. Esta condición representa el 53 -77% de todas las neoplasias de glándulas salivales. Afecta principalmente a las glándulas salivales mayores; sin embargo, las glándulas salivales menores, es poco representando, con un 8-10% de los casos, principalmente en el paladar y el labio, cavidad nasal, faringe, laringe y tráquea. El diagnóstico confirmatorio se realiza mediante un estudio histopatológico. El tratamiento indicado es la resección amplia del tumor. Por lo que es de elemental importancia conocer la técnica quirúrgica para evitar la recurrencia de la neoplasia. Por ello, el objetivo del presente artículo es presentar tres casos representativos de AP localizados en sitios poco frecuentes como son las glándulas salivales menores.

Dentist attitudes and responsibilities concerning child sexual abuse: a review and a case report

According to the World Health Organization, child abuse and neglect is “every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”. The aim of the present report is to inform about the most relevant aspects of child abuse and the characteristics of injuries to the head, neck, and orofacial regions, in addition to the suggested role of, and management by, the dentist for the evaluation of this condition, and also for reporting a case of a physically and sexually abused girl aged 5 years 8 months. Throughout the appointments, some type of abuse in this patient was suspected by the treating dentists at the clinic, mainly due to the initial behavior exhibited by the patient in the dental chair. Based on the clinical diagnostic an intensive preventive plan and restorative treatment was realized. The timely detection of the signs and symptoms of sexual abuse, often present in the orofacial region, place the pediatric dentist in a strategic situation, with the capacity to recognize, register, and later report those cases considered as suspect, including the dental treatment delivered and the intensive behavioral-psychological management, in order to achieve acceptation by the otherwise very anxious patient of the indicated restorative and preventive dental procedure

Management of the oral hemangiomas in infants and children : scoping review

Pediatric oral hemangiomas are benign vascular tumors that can be seen from birth, particularly in females. Hemangiomas are most frequent located in the lips and usually regress spontaneously, thus they do not require any type of treatment in most cases. The present scoping review pretended to synthesize the most relevant and currently available information from the international dental literature published in the last 25 years, regarding the management of pediatric oral hemangiomas. An exhaustive literature search was performed in four electronic databases (PubMed, Embase, Google Scholar, and Cochrane). Initially, 241 related titles and abstracts were found. After the duplication removal, screening, and assessment processes, 37 records were included for full-text reading. Finally, 20 articles in the English language were included in the scoping review for data extraction and assessment. We identified and subsequently discussed three fundamental issues associated to the management of pediatric oral hemangiomas: (i) clinical characteristics, differential diagnosis, and histopathological findings; (ii) evolution and complications; and (iii) current available treatment modalities. Although these like-tumor lesions are uncommon, pediatric dentistry practitioners must be familiar with the inherent clinical characteristics, diagnosis approaches, and currently available treatment options. Nowadays, surgical removal and non-invasive medical/pharmacologic therapies are the best management modalities for pediatric oral hemangiomas

Non-syndromic craniosynostosis in children : scoping review

Craniosynostosis (CS) is a complex condition consisting of the early fusion of one or more cranial sutures in the intrauterine stage. The affected infant exhibits abnormal head shape at time of birth or shortly thereafter. It can be observed in normal individuals (non-syndromic CS or NSCS) or as a part of a multisystem syndrome. The purposes of the present article were to carry out a scoping review on Non-Syndromic CS and to discuss the most important findings retrieved. The steps of this scoping review were as follows: first, to pose a research question; second, to identify relevant studies to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles. Relevant articles published over a 20-year period were identified and retrieved from five Internet databases: PubMed; EMBASE; Cochrane Library; Google Scholar, and EBSCO. Fourteen articles were finally included in the present scoping review. The following four most important clinical issues are discussed: (i) normal cranial development, clinical manifestations, and pathogenesis of NCSC; (ii) clinical evaluation of NCSC; (iii) treatment and post-surgical follow-up; and (iv) additional considerations. NSCS may be present with associated head shapes. Multiple early surgical reconstructive options are currently available for the disorder. Pediatric Dentistry practitioners must be familiarized with this condition and form part of a multi-approach health team as those responsible for the opportune oral health care of the affected child

Early identification of permanent maxillary canine impaction : a radiographic comparative study in a Mexican population

Opportune diagnosis, prediction, and interceptive treatment of permanent maxillary canine (PMC) impaction is fundamental for pediatric dentists and orthodontists. In children and young adolescents, diagnostic information obtained from a panoramic radiograph is valuable for the overview and prediction of a potential PMC ectopic eruption into the oral cavity. The aim of the present study was to calculate and compare the prevalence of impaction of PMC in a Mexican pediatric sample (7 to 13 years old), through the use of the Ericson & Kurol (EK/L) and the Power & Short (PS) measurement analyses performed on panoramic radiographs. This investigation was a cross-sectional study performed on 515 panoramic radiographs, which were evaluated to assess the intraosseous position of right and left PMC, from patients who had attended our clinic between 2010 and 2017. Both analytical methods were applied on the same radiography. Outcomes from both analysis methods were expressed dichotomously (impacted or non-impacted). Thus, prevalence was calculated from each method, and the difference between them was verified through the Pearson?s Chi-square test. No statistical difference could be detected between both prevalence rates (p = 0.475). It was found a significant predilection of the condition to the female sex (p = 0.034). Further, the two radiographic methods employed here were highly concordant each other (kappa = 0.92). Through the EK/L method a PMC prevalence of 5.64% (95% CI = 3.66, 7.62) was obtained, while the PS Method the prevalence was 8.83% (95% CI = 6.38, 11.28). In addition, a significant predilection of canine impaction to the female gender was found

Moxifloxacin versus Clindamycin/Ceftriaxone in the management of odontogenic maxillofacial infectious processes: a preliminary, intrahospital, controlled clinical trial

Background: The aim of this study was to compare the days of hospitalization length between patients treated with Moxifloxacin with that of patients treated with a Clindamycin/Ceftriaxone combination and additionally, to isolate and identify the oral pathogens involved in orofacial odontogenic infections. Material and Methods: A pilot-controlled-clinical-trial was carried out on hospitalized patients with cervicofacial odontogenic abscesses or cellulitis, who were randomly asigned to two study groups: 1) patients who received Moxifloxacin, and 2) patients receiving Clindamycin/Ceftriaxone combination. Infiltrate samples were collected through transdermic or transmucosal punction and later cultured on a media specific for aerobic and anaerobic microorganisms. Mean hospitalization duration in days until hospital discharge and susceptibility assessment in rates were established. Results: Mean hospitalization time in days of patients treated with Moxifloxacin was 7.0 ± 1.6 days, while in the Clindamycin/Ceftriaxone group, this was 8.4 ± 1.8 days, although significant difference could not be demonstrated ( p =0.074). A total of 43 strains were isolated, all of these Gram-positive. These strains appeared to be highly sen - sitive to Moxifloxacin (97.5%) and Ceftriaxone (92.5%). Conclusions: Moxifloxacin and Ceftriaxone appear to be potential convenient and rational alternatives to traditional antibiotics, for treating severe odontogenic infections, in conjunction with surgical extraoral incision, debridement, and drainage

Dental approach for Apert syndrome in children : a systematic review

Apert Syndrome (AS), or type I acrocephalosyndactyly, is a rare, congenital craniosynostosis condition resulting from missense mutations in the gene encoding fibroblast growth factor receptor 2. It is characterized by three specific clinical features: brachycephalic skull; midface hypoplasia, and limb abnormalities (syndactyly of hands and feet). The disorder exhibits variable presentations in bones, brain, skin, internal organs, and in the oral/maxillofacial region. The aim of the present paper was to show the main results from a systematic review of AS. A search of the literature was performed from April to June 2016 in five electronic databases. Clinical interventional or observational studies, reviews, and case reports were included. The present systematic review was carried out strictly following PRISMA and Cochrane Collaboration criteria. A total of 129 potential references were identified. After reviewing titles and abstracts, 77 of these did not meet the desired criteria and were discarded. The full text of the remaining 52 manuscripts was critically screened. Finally, 35 relevant papers were identified for inclusion in the present systematic review and classified according to topic type. According to the information gathered, dentistry practitioners must be able to supply an early diagnosis through the recognition of AS clinical features and provide correct oral management. Additionally, they should be integrated in a multidisciplinary medical care team in order to improve the quality of life of the affected patients

Dental Considerations in Children with Glucose-6-phosphate Dehydrogenase Deficiency (Favism): A Review of the Literature and Case Report

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an uncommon inherited enzyme deficiency characterized by hemolytic anemia, caused by the inability of erythrocytes to detoxify oxidizing agents such as drugs, infectious diseases, or fava bean ingestion. In this later case, the disorder is known as favism. The aim of the present report was to present a review of the literature in this disease, to describe a case report concerning an affected 9-year-old male, and to review the main implications and precautions in pediatric dental management

Dental Management of a Child with Incidentally Detected Hemophilia: Report of a Clinical Case

Children with hemophilia (A or B) are at risk for bleeding episodes, which rank from mild mucosal/soft tissues bleeding to life-threatening hemorrhages. This report describes the dental/medical management provided to an 8.10-year-old patient suffering from uncontrolled bleeding after a surgical procedure to expose both permanent upper central incisors, in which hemophilia was a pure incidental finding. Additionally, diverse precautions to be considered during the dental clinical treatment of hemophilic children are discussed