Malignant minor salivary gland tumors: a retrospective study of 27 cases

Purpose: Malignant tumors of the intra-oral minor salivary glands are uncommon. The aim of this study was to give information concerning the clinical features of these tumors, the distribution of location, treatment opportunities, and outcome. Methods: Twenty-seven patients with malignant salivary gland tumors that were treated between January 1999 and December 2008 were evaluated retrospectively. Results: Of the 27 minor salivary gland carcinomas, 48.1% were adenoid cystic carcinomas (ACC), 29.7% mucoepidermoid carcinomas (MEC), 22.2% adenocarcinomas (ADCA). The most common first symptom was a painless swelling in 60% of the cases, with the second most common symptom being ulcers (28%). Four recurrences and two metastases were found. No recurrence was observed in ADCA. All four patients experiencing a recurrence developed it in the first 3years after treatment. Conclusion: Wide excision with a clinical margin of 1cm and in large tumors, positive surgical margins or perineural infiltration and postoperative radiotherapy (RT) can be recommended; but in order to give exact information concerning the possible benefit from postoperative RT, it needs large prospective multicenter studies. Long-term follow-up controls and in particularly longer than 5years in ACC including yearly chest X-rays should be offered to these patients because of late metastasis and recurrence

Amoxicillin mit Clavulansäure Standardantibiotikum im allgemeinzahnärztlichen Alltag

This script gives a pragmatic advice for general dentists on accurate use of amoxicillin with clavulanic acid considering current literature at acute inflammatory disease. In absence of contraindications a twice daily formulation of 1g amoxicillin with clavulanic acid is the first choice for concomitant therapy after treating the cause of inflammation or prophylaxis. Compared to clindamycin the concentration of amoxicillin in teeth and bone (Hallig 2014) is higher and has less gastrointestinal side-effects (Bax 2007). Furthermore it is prescribable during pregnancy and lactation. With these advantages amoxicillin with clavulanic acid is the first choice of antibiotics in general dental medicine

TABOTAMP® in Oral and Maxillofacial Surgery – mechanism, indications and contraindications

Since the 1950s, oxidised regenerate cellulose (TABOTAMP ®) has been successfully applied for local haemostasis in intra- or postoperative bleeding complications. The scope of this medical product is large and it has found its place in oral and maxillofacial surgery. Although the application of TABOTAMP ® in medicine and dentistry is common, further complications next to the absence of the haemostatic effect may be encountered if used incorrectly. The aim of this article is an update on the proper use of TABOTAMP ®. Further, tips are provided for the indication-specific application of this useful agent in clinical practice

Komplikationen der zahnärztlichen Lokalanästhesie

Local anaesthetics are an integral part of most dental procedures and are therefore widely used and safely applied. Though rare, complications may occur and can be categorized as local or systemic. In the majority they are of minor nature but there is a potential for severe and possibly lethal side effects. Local complications are nerve damage (mainly the lingual and the inferior alveolar nerve), lesions of vascular structures, hematoma formation, temporary palsy of the facial nerve and post injection pain being the most common local complication. Examples for systemic complications are allergic reactions, cardiovascular complications, intoxication and psychogenic reactions

Complications de l'anesthésie locale en médecine dentaire

Local anaesthetics are an integral part of most dental procedures and are therefore widely used and safely applied. Though rare, complications may occur and can be categorized as local or systemic. In the majority they are of minor nature but there is a potential for severe and possibly lethal side effects. Local complications are nerve damage (mainly the lingual and the inferior alveolar nerve), lesions of vascular structures, hematoma formation, temporary palsy of the facial nerve and post injection pain being the most common local complication. Examples for systemic complications are allergic reactions, cardiovascular complications, intoxication and psychogenic reactions

Charles Bonnet syndrome in cranio-maxillofacial surgery: case report

Background: Complex visual hallucinations in the presence of a clear mental state and in the absence of underlying neurological disorders have received increased recognition since Charles Bonnet reported visual hallucinations secondary to mature cataracts in 1760. The prevalence of Charles Bonnet syndrome (CBS) varies widely in the literature and might be underestimated in most settings. The current paper presents a case of acute-onset CBS due to a unilateral Frost suture after revision of an orbit floor fracture. Case report: A 68-year-old male patient underwent an operation to repair a unilateral orbital floor fracture and subsequent eye patching by a Frost suture. The patient complained of complex, colored visual hallucinations ∼3h after waking from general anesthesia. The visual hallucinations stopped during sleep and reappeared in the morning. The symptoms disappeared completely ∼2h after removal of the Frost suture. Discussion: Frost sutures are commonly used in oculoplastic surgery and may result in acute onset of visual hallucinations. CBS is often neglected, and clinicians must be aware of the association between acute visual deprivation and CBS

A case report of metastasis of malignant mesothelioma to the oral gingiva

Introduction: Metastatic mesothelioma to the oral cavity arises from the pleura or peritoneum and distant hematogenous metastases are seen in more than half of cases but only a few cases are reported to the oral cavity Case: A 75 year old male suffering from metastatic mesothelioma presents an hyperplasia of the attached gingiva. Malignant mesothelioma is a rare tumour arising from pleura, pericardium or peritoneum. Conclusion: This article highlights the importance of biopsy and histopathological diagnosis of oral lesions especially in case of a malignant history

Solcoseryl® Dental-Adhäsivpaste - Wirkmechanismus und Risiken

Solcoseryl® is a protein-free haemodialysate, containing a broad spectrum of low molecular components of cellular mass and blood serum obtained from veal calves. Solcoseryl® improves the transport of oxygen and glucose to cells that are under hypoxic conditions. It increases the synthesis of intracellular ATP and contributes to an increase in the level of aerobic glycolysis and oxidative phosphorylation. It activates the reparative and regenerative processes in tissues by stimulating fibroblast proliferation and repair of the collagen vascular wall. The formulations of Solcoseryl® are infusion, injection, gel and ointment, and it is also available as a dental paste for inflammatory processes of the mouth cavity, gums and lips

Bone mineral density measurements performed by cone-beam computed tomography in the bisphosphonate-related osteonecrosis-affected jaw

Objectives: The aims of this study were to determine the bone mineral density (BMD) in bisphosphonate-related osteonecrosis of the jaw (BRONJ) by cone-beam computed tomography (CBCT) measurements and to correlate these measurements with the current stages recommended by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Methods: Bone mineral density measurements of various areas in 24 bisphosphonate-related osteonecrosis (BRON) jaws were evaluated by CBCT. Another 24 age- and sex-matched patients without any bone pathologies served as the control group. Data acquisition was highly standardized to ensure maximum reliability in the comparisons of BMD measurements by CBCT. Results: Compared with the control group, the bisphosphonate patients had significantly higher (p≤0.01) BMDs in the non-affected jaw areas ipsilateral and contralateral to the BRON within the maxilla and mandible. The highest BMDs within the BRON jaws were observed in the BRON-adjacent areas relative to the non-affected ipsilateral and contralateral areas. Regarding the correlation with the AAOMS stages, the BMDs of the evaluated areas of BRONJ showed no significant differences (p≥0.05) between the stages. Conclusions: Bisphosphonate-related bone pathologies can be detected by CBCT and are associated with increased BMDs, not only in clinically obvious BRONJ areas, but also in clinically unapparent areas, suggesting a subclinical general osteosclerosis of the jaw. The data transferability to other CBCT devices needs to be further elucidated and compared with multislice C

Is radical surgery of an inverted papilloma of the maxillary sinus obsolete? a case report

Abstract Background Sinonasal inverted papilloma is a locally aggressive tumor arising from the Schneiderian membrane which lines the nasal cavity and paranasal sinuses. Aggressive surgical approaches, such as lateral rhinotomy, were used until recently for complete removal of the inverted papilloma. Currently, endoscopic resection is the gold standard in the treatment of inverted papilloma. However, there are situations that justify an open approach. For example there are studies that report a higher postoperative recurrence rate after endonasal endoscopic resection, particularly in the treatment of recurrent diseases. While endoscopic resection performed by an experienced surgeon is definitely a minimally invasive therapy, an open approach is not necessarily associated with functional and aesthetic disadvantages. This case report describes the treatment of inverted papilloma by an open approach. This has been described before but the new gold standard of endoscopic resection has to be taken into account before any treatment decision is made nowadays. Case presentation Contrast-enhanced magnetic resonance imaging of the head and neck area was indicated in a 72-year-old white German man who presented with suspected squamous cell carcinoma of his lower lip. Magnetic resonance imaging additionally revealed a 3×2 cm2 polycyclic arranged mucosal thickening with cystic and solid contrast affine shares at the antral laterocaudal area of his right maxillary sinus, extending from his right lateral nasal wall to his maxillary sinus floor. He received antral polypectomy with medial maxillectomy via a unilateral LeFort I osteotomy approach. His pterygoid plate was preserved. A histological examination demonstrated a tumor composed of hyperplastic squamous epithelium protruding into the stroma (surface epithelial cells grew downward into the underlying supportive tissue), thus producing a grossly convoluted cerebriform appearance. Two weeks later, the patient regained a well-formed maxilla without any restrictions. He has remained disease-free for 25 months following the surgery and surveillance was continued in our tumor clinic. Conclusions Endoscopic resection of an inverted papilloma continues to be the gold standard. However, some cases require a radical approach. This does not necessarily increase patient morbidity