Accidental displacement of a dental implant into the sublingual space: a case report

Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication

Cervical necrotizing fasciitis and acute mediastinitis of odontogenic origin: a case series

Necrotising fasciitis (NF) is an uncommon infection. Early signs and symptoms include fever, severe pain and swelling, and redness at the wound site. Moreover, fulminant evolution and high mortality rate are typical of this pathology. In the present report we describes three cases of cervical necrotizing fasciitis complicated by acute mediastinitis. All patients were apparently immunocompetent adults. The main aim of the present report is to show the serious consequences that a dental infection might trigger. Furthermore, we highlight the importance of a multidisciplinary approach in these cases. The constant interaction between different medical specialties is essential for ensuring a proper management of each case

Traumatic arteriovenous fistula as consequence of TMJ arthroscopic surgery: a case report

The ocurrence of a traumatic arteriovenous fistula after arthroscopic surgery of TMJ represents an extremely rare event. Specifically, this uncommon complication has been described only in a few case reports. In this light, the most frequent symptoms showed by this disease are thrills, bruits, pulsatile tinnitus, and an expansible vascular mass. Importantly, the severity of these symptoms is also dependent on the vessels involved. With regard to the management, is important to note that the vessel ligation with surgery as well as vessel emolization with endovascular procedures have been shown to be effective in the treatment of these cases. In view of that, the present study describes a case of superficial temporal arteriovenous fistula that arose as a postoperative complication of a bilateral arthroscopic eminoplasty of TMJ. The aim of the present report is to characterize this rare syndrome with the goal of proposing suitable treatments

Meningitis and subdural empyema as complication of pterygomandibular space abscess upon tooth extraction

Complication of dental infections might be various and heterogeneous. The most common complications are represented by maxilar celulitis, canine space celulitis, infratemporal space celulitis, temporal celulitis and bacteremia. Among rarest complications we found: sepsis, bacterial endocarditis, mediastinitis, intracranial complications, osteomyelitis, etc. Although dental infections are often considered trivial entities, sometimes they can reach an impressive gravity. In this regard, the present study describes a case of dental infection complicated by meningitis, subdural empiema and cerebral vasculitis. Furthermore, we observed other neurological complications, like thalamic ischemic infarction, during the disease evolution. Noteworthy, these entities were not presented when the patient was admitted to hospital. Therefore, the main aim of this report is to highlight the serious consequences that an infection of dental origin could cause

Juxtacortical mandibular chondrosarcoma during pregnancy : a case report

Chondrosarcoma is one of the most common malignant bone tumors in adults. It use to affect upper arm, pelvis and thigh bone. A wide surgical extirpation represent the gold standard to treat this disorder. In fact, radiotherapy and chemotherapy are no useful. Interestingly, chondrosarcoma is rare in head and neck (HNCS) and extremely uncommon during pregnancy. Thus, there is a lack of evidence about the proper treatment in these cases. A wide surgical extirpation is also considered the most effective procedure in HNCS. There are no consistent evidences about the he role of radiation and chemotherapy. In view of that, the present study describes a case of juxtacortical mandibular chondrosarcoma affecting a 28-year-old pregnant woman. After a multidisciplinary analysis of the case, we decided to treat the patient with a wide surgical resection and and immediately reconstruction

Oral and oropharyngeal squamous cell carcinoma in young adults : a retrospective study in Granada University Hospital

This study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients 45 years were randomly selected from the same database. A retrospective analysis was conducted to determine specific features including sites of occurrence, risk factors, sex distribution, socio-economic status, T stage at diagnosis, nodal involvement, degree of tumor differentiation, locoregional failure and overall survival at 5 years was. Further, the results of both groups were compared. The male-female ratio was 1.2:1 in the group of young adults and 2.03:1 in the group of patients with an age of >45 years. No significant differences were found in terms of site, nodal involvement, locoregional failure, and overall survival. However, there were statistically significant differences between the two groups in terms of features such as risk factors, socio-economic status, T stage at diagnosis, and degree of tumor differentiation. The overall 5-year survival rate was 62% for patients >45 years old, whilst for the group of young adults this rate was 48.4% (p= 0.17). The poor association between the common risk factors and oral and oropharyngeal cancers in young adults suggests that other pathogenic mechanisms should be investigated. For young patients, the data show evidence of poorer outcomes in terms of overall survival (p=0.17), and locoregional failure (p=0.23). Nevertheless, the literature shows that the results in this field are particularly inconsistent, and further research is therefore needed to provide more in-depth knowledge of the disease in this age group

Los niños del Cauca. I. Descripción de un foco de raquitismo dependiente de la vitamina D, Tipo II.

A large group of patients with low extremity deformities (genu varurn, genu valgun or both) was detected in the northern area of the Cauca department. Those deformities resembled a rickets picture, both clinically and radiolocically. Most of them carne from a semi-isolated population group of Afro-mestizo ancestry, located in La Toma county, Suárez municipality. Comparative biochemical studies between 64 patients and 109 sane subjects (first degree relatives) showed as light hypocalcemia, increased sericphosphorus levels, amarkedly high alkaline phosphatase titers, normal protein and albumin values,and high parathormone serictiters. Twenty four hour urinalysis showed hypocalciuria and hypophosphaturia. 25(OH)D,and 1a,25(OH),D3 seric titers were determined to establish rickets type. There was a marked increase of 1, 25 (OH) D, allowing us to conclude that it corresponded to vitamin D-dependet-rickets, type II.Thelatter is an autosomal recessive genetically transmitted rickets with clinical and laboratory manifestations due to a defect in the vitaminD receptor. One hundred and fifteen patiens started therapy with 1u. 25 (OH). D, (0.50 ug/d), calcium (1,840 mg/d), phosphorus (1,424 mg/d) given in two doses per day. Serum titers of 21 patients were analysed before and after treatment, and values tended to become normal. Molecular studies, mRNA and cDNA vitamin D receptor gen, obtained from fibroblast cultures from two patients with severe compromise, showed a normal nucleotide sequence. A comparison between clinical and laboratory findings of the 20 reported cases in the literature and our 64 cases was done; we emphasize our observations, including the early onset of the clinical picture, pain or muscular weakness absence, without baldness, normal phosphorus values and a slight secundary hyperparathy roidism, which indicates the great heterogeneity of this particular type of rickets.Al norte del departamento del Cauca se detectó un numeroso grupo de pacientes con deformidades en miembros inferiores (genu varo, genu valgo o ambos) que correspondían clínica y radiológicamente a un cuadro de raquitismo. Ninguno de los pacientes presentaban alopecia, miopatia, tetania o aminoaciduria. La mayoría deellos proceden de un grupo poblacional semiaislado de ancestro afromestizo, en el corregimiento de La Toma, del municipio de Suárez. Los estudios bioquímicos comparativos entre 64 pacientes y 109 individuos no afectados, parientes en primer grado, mostraron en los pacientes una ligera hipocalcemia, niveles normales altos de fósforo sérico, un sustancial incremento de la fosfatasa alcalina,valores normales de proteínas y albúminas y niveles séricos de paratohormona aumentados. Estudios en orina de 24 horas mostraron hipocalciuria e hipofosfaturia. A un subgrupo de 8 pacientes se les determino niveles séricos de la 25 (OH)D, y l<r,25(011).A para establecer a qué tipo de raquitismo pertenecían nuestros pacientes. Se observó un marcado incremento de lcr, 25(OH),A3, por lo que esta patología corresponde al raquitismo dependiente de la vitamina D, tipo II. Se trata de un tipo de raquitismo genético transmitido en forma autocómica recesiva, cuyas manifestaciones clínicas y de laboratorio se presentan por un defecto en la acción del receptor para la vitamina D. A 115 pacientes se les inició tratamiento con 1a,25(OH),A3 hig 0,50/día, calcio 1.840 mg/día y fósforo 1.424 mg/día, administrados en dos dosis diarias. En un grupo de 21 pacientes, se analizaron los datos de laboratorio en suero, pre y posttratamiento un ano después y todos los valores tendieron a normalizarse. Estudios moleculares, del mRNA y cDNA del gen del receptor de la vitamina D, obtenidos de cultivo de fibroblastos de dos de los pacientes más severamente afectados, mostraron una secuencia normal de nucleótidos. Se hace una comparación entre los hallazgos clínicos y de laboratorio entre los 20 casos informados hasta el momento en la literatura con este tipo de enfermedad y los 64 casos que analizamos en el presente estudio, enfatizando nuestras observaciones, como el inicio temprano de las manifestaciones clínicas, ausencia de dolor o debilidad muscular, de alopecia, de niveles normales de fósforo y leve hiperparatiroidismo secundario, lo que indica una gran heterogeneidad en este tipo de raquitismo

La neumonía por aspiración en pacientes sometidos a cirugía de cabeza y cuello. Una serie de casos

Patients underwent head and neck surgery might present numerous respiratory and gastrointestinal complications. The need to administrate enteral nutrition for long time periods promotes the emergence of such problems. In this line, is important to underline that these complications could be life threatening for the patients. The main aim of the present report is to examine the importance of performing a radiographic control after a NG tubes placement. We firmly believe that it represent the most reliable method to avoid respiratory complications related with NG tubes in high risk patients.Los pacientes sometidos a cirugía de cabeza y cuello pueden presentar numerosas complicaciones respiratorias y gastrointestinales. La necesidad de administrar la nutrición enteral durante largos períodos de tiempo promueve la aparición de tales problemas. En esta línea, es importante subrayar que estas complicaciones podrían poner en peligro la vida de los pacientes. El objetivo principal del presente informe es examinar la importancia de realizar un control radiográfico después de una colocación de tubos NG. Creemos firmemente que representa el método más fiable para evitar las complicaciones respiratorias relacionadas con los tubos NG en pacientes de alto riesgo

Maxillary advancement in cleft palate patients with intraoral distraction

AbstractIntroductionPatients with cleft lip and palate usually present with maxillary hypoplasia. Upper jaw intraoral distraction osteogenesis (DO) is an alternative technique for patients with severe maxillary hypoplasia. An evaluation was made of the changes produced in hard and soft tissues and their stability over time.Material and methodsSix patients (5 female and 1 male) between 16 and 25 years old with cleft lip and palate underwent maxillary DO with an internal distractor. An evaluation was made of the skeletal and soft tissues changes using cephalometric studies with radiographs and photographs. Follow-up time was between 2 and 8 years.ResultsThere was Point A advancement between 3 and 10mm in 5 patients, significantly improving maxillomandibular relationships. Intraoral DO failed in one patient, and the case was finished using rigid external distraction (RED). In another patient hardly any advancement and maxillary rotation was observed. The relapse observed between 6 and 9 months post DO was between 10 and 15% in both skeletal and soft tissues.ConclusionsIntraoral DO is a successful alternative technique in maxillary advancement in patients with cleft lip and palate who need an advancement less than 10mm. It produces improvements in the skeletal and soft profile. Internal devices do not have any psychological impact and have longer consolidation phases. Relapse is difficult to determine and calculate