Effectiveness of Direct Bite Raiser Onlays in Patients Affected By Temporomandibular Disorders: A Retrospective Observational Study

This retrospective observational study aims to assess the effectiveness of direct bite raiser onlays (DBRO) on pain and dysfunctional symptoms in patients affected by pain-related temporomandibular disorders (TMD). Furthermore, it wants to provide descriptive information about the clinical performance of the treatment. We screened the electronic medical records of male and female patients with a diagnosis of pain-related temporomandibular disorders treated with DBRO. A data collection was performed from patients routinely gathered clinical records. A final sample of 43 patients was included in the analysis. At the beginning of treatment all patients (100%) referred having pain and 12 patients (27.9%) complained about both pain and functional limitation. At the end of the treatment, 36 patients (83.7%) were symptom-free. In 5 subjects (11.6%), pain was still present but reduced in intensity. In 2 subjects (16.6%) functional limitations were improved but not completely resolved. During the treatment that lasted on average 8 months a mean of 7 checks have been carried out; the occlusal changes made on the DBRO had been on average 3. In 23 patients (53.5%) initial discomfort occurred after the beginning of treatment. The first beneficial effect was obtained on average on the fifth week of therapy. The results of this retrospective observational study should be treated cautiously because of the limitations of the study design but suggest that patients with a diagnosis of pain-related temporomandibular disorders who are treated with direct bite raiser onlays experience a reduction in pain and dysfunctional symptoms

Mother and Daughter Carrying of the Same Pathogenic Variant in FGFR2 with Discordant Phenotype

Craniosynostosis are a heterogeneous group of genetic conditions characterized by the premature fusion of the skull bones. The most common forms of craniosynostosis are Crouzon, Apert and Pfeiffer syndromes. They differ from each other in various additional clinical manifestations, e.g., syndactyly is typical of Apert and rare in Pfeiffer syndrome. Their inheritance is autosomal dominant with incomplete penetrance and one of the main genes responsible for these syndromes is FGFR2, mapped on chromosome 10, encoding fibroblast growth factor receptor 2. We report an FGFR2 gene variant in a mother and daughter who present with different clinical features of Crouzon syndrome. The daughter is more severely affected than her mother, as also verified by a careful study of the face and oral cavity. The c.1032G>A transition in exon 8, already reported as a synonymous p.Ala344 = variant in Crouzon patients, also activates a new donor splice site leading to the loss of 51 nucleotides and the in-frame removal of 17 amino acids. We observed lower FGFR2 transcriptional and translational levels in the daughter compared to the mother and healthy controls. A preliminary functional assay and a molecular modeling added further details to explain the discordant phenotype of the two patients

Tonsillar metastasis of gastric cancer

Metastasis from a malignant tumor to the palatine tonsils is rare, with only 100 cases reported in the English-language literature. Tonsillar metastasis from a gastric cancer is very rare. We report here a case of palatine tonsillar metastasis after gastric cancer surgery. The patient was an 88-year-old woman who had gastric cancer with abdominal wall invasion. She had undergone a distal gastrectomy with abdominal wall resection and D2 lymph node dissection. Histologically, the tumor was primarily a moderately differentiated adenocarcinoma. It was stage IV (T4, N1, M0) using TNM clinical classification. The patient developed pharyngeal discomfort and abdominal pain and was hospitalized during the follow-up period, 1 year 9 months post-operatively. Multiple lung metastases, Virchow’s lymph node metastasis, and adrenal metastasis were observed. A mass of 2.5 cm was also observed in the right palatine tonsil. It was diagnosed as a moderately differentiated adenocarcinoma, a metastasis from gastric cancer. There was a concern of asphyxiation due to hemorrhage of the tumor; however, the tumor dislodged approximately 10 days after biopsy and tonsillar recurrence was not observed. The patient died 1 year 10 months post-operatively. In the literature there are cases with tonsillar metastases where surgical treatment, radiotherapy, and chemotherapy were performed and extension of survival was seen. Tonsillar metastasis is a form of systemic metastasis of a malignant tumor, and there is a high risk for asphyxiation from tumor dislodgement or hemorrhage. Thus, it is important to recognize tonsillar metastasis as an oncologic emergency

Gli epiteliomi cutanei in pazienti portatori di altre neoplasie

SUMMARY Basal and squamous cells carcinoma in patients affected by others cancers. Skin cancers are a common disease, but unusual is their association with other tumors. The Authors have studied the patients presenting skin cancers (BCC and SCC) in association with a cancer not involving the cutaneous district, with the purpose to evaluate ali the possible ethiologies of the skin cancer. This retrospective research has included all the people treated for BCC and/or SCC by the Plastic Surgery Unit of the University of Rome «La Sapienza», during 36 months (March 1987-May 1990). In this time 433 people have been treated for skin cancers, among them nine (7 males, 2 females) presented also another neoplastic disease. We have observed three kinds of links among the neoplastic associations: the cutaneous neoplasy may rise as a consequence of an organic-immunologic deficit in the patient, may be caused by the treatment underwent to heal from the first cancer, or the association seems to happen by hazar

Ear reduction.

Four cases of ear reduction for congenital macrotia and ear asymmetry are presented. To minimize the visible scarring the technique of helical advancement was used. The indications for this uncommon procedure are discussed with a review of the literature. This simple technique has been effective in achieving the desired reduction, leaving the scar hidden in the eaves of the helix, and we endorse its wider use

Carcinomi cutanei in pazienti portatori di leucosi croniche

associazioni che possono esistere tra i tumori di origine epiteliali e le neoplasie maligne di origine ematologico e in particolar modo le forme leucemiche. Negli ultimi: tempi infatti le osservazioni di associazioni di queste forme tumorali sono sempre più frequenti sia per l'aumentata età media di sopravvivenza dei pazienti portatori di forme neoplastiche ematologiche, sia per una migliore diagnostica nel campo dei tumori cutanei. Gli Autori dopo aver eseguito una revisione della letteratura e di aver analizzato alcuni casi pervenuti alla loro osservazione, considerano: 1) le possibili interrelazioni tra le due forme neoplastiche, 2) il trattamento dell'epitelioma cutaneo; 3) la prognosi

Patient’s proprioceptive remnants in nipple reconstruction planning

Abstract. – OBJECTIVE: The aim of this study is to demonstrate that for patients undergoing mastectomy the use of the proprioceptive memory represents a valid method to identify the perfect position of the nipple, which will be reconstructed on an operated breast. PATIENTS AND METHODS: Fifty-one patients undergoing breast reconstruction after unilateral Modified Radical Mastectomy or unilateral Skin Sparing Mastectomy were included in the study. All patients were asked to identify, while keeping their eyes closed, the mammary segment where they perceived their nipples, both on the reconstructed breast mound and on the contralateral breast. Sternal Notch-to-nipple distance (SN), Nipple-to-inframammary Fold distance (NF), Midclavicular line-tonipple distance (CN), the distance from the nipple to the chest Midline (NM), Anterior Axillary line-to-nipple distance (ZN) were measured on both breasts. The ideal position of the nipple to be reconstructed was evaluated using a geometric method based on the Pythagorean Theorem. RESULTS: A statistically significant correlation emerges between the distances measured from the anatomical landmarks of the chest to the point coinciding with the patient’s perception of the nipple on the reconstructed breast, and the distances measured from the same chest landmarks to the nipple on the contralateral native breast and to the nipple placed in the ideal position assessed with the geometric method. CONCLUSIONS: The patient’s proprioceptive memory of the nipple position can be useful to identify the exact place to reconstruct the nipple in breast reconstruction