TMJ metastasis: A unusual case report

The metastases to the TMJ from a primary lung tumour is a very rare occurrence

Aneurysmal Bone Cyst located in the Mandibular Condyle

A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced

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Surgical Orthodontic Treatment of a Patient Affected by Type 1 Myotonic Dystrophy (Steinert Syndrome)

Myotonic dystrophy, or Steinert’s disease, is themost common formofmuscular dystrophy that occurs in adults.Thismultisystemic form involves the skeletalmuscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. Theweakness of the facialmuscles causes a characteristic facial appearance frequently associated with malocclusions. Young people withmyotonic dystrophy, who also have severemalocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient’s need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient’s quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases

Alveolar ridge augmentation with maxillary sinus elevation and split crest: Comparison of 2 surgical procedures

The purpose of this study was to evaluate the clinical and radiological outcomes of 2 piezosurgical split techniques performed in conjunction with the sinus lift.The present retrospective study included 20 patients with edentulism of the posterior maxilla who had undergone the sinus lift and alveolar ridge split treatment separately or the sinus lift combined with the monoblock alveolar ridge split. Differences between these 2 techniques were analyzed.All the surrounding areas successfully produced an adequate bone volume for the insertion of implants. A clinical evaluation showed a mean vertical augmentation of 3.6 ± 0.4 mm in Group A and 3.2 ± 0.7 mm in Group B. With regards to the lateral augmentation, the clinical evaluation gives a mean gain of 5.2 ± 0.3 mm in Group A and 4.9 ± 0.5 mm in Group B. The mean vertical and horizontal bone augmentation recorded for both types of surgical procedures were comparable.The proposed surgical procedures enabled the tridimensional volume of the alveolar ridge to be recreated. This resulted in the creation of a natural contour of hard and soft tissues which enabled a functional and aesthetic rehabilitation of the edentulous posterior maxilla to be obtained

La Geomatica a supporto dell'analisi critica della metodologia PAI in Sardegna.

In un progetto finanziato dall’Agenzia del Distretto Idrografico della Sardegna, si sta conducendo un’analisi critica della normativa e delle Linee Guida del Piano di Assetto Idrogeologico (PAI) relativamente alla sezione che, attraverso l’analisi di specifici indicatori pesati, porta dapprima all’individuazione delle aree potenzialmente instabili e di seguito alle carte di pericolosità e rischio. Il presente lavoro illustra le attività di analisi delle criticità, unitamente allo sforzo di fornire una caratterizzazione più strettamente geologica ai fenomeni di instabilità dei versanti. Nella metodologia attualmente in vigore gli aspetti geologici non contemplano la complessità stratigrafica e geometrica dei territori e dei fenomeni di instabilità. In particolare, la classificazione meccanica delle litologie che viene suggerita, frutto di studi condotti in contesti geologici diversi, non sembra essere coerente con le fenomenologie franose che si sviluppano nell’Isola. Particolare rilevanza viene attribuita all’esposizione dei versanti come concausa di fenomeni franosi, mentre questo aspetto non sembra avere alcuna influenza. Diversamente, emerge una stretta relazione tra litologie, classi di pendenza e sistemi di discontinuità per le frane per crollo e ribaltamento, tipologie di frana più frequenti nell’Isola. Le relazioni tra diverse tipologie di fenomeno franoso, litologie, classi di pendenza e altri parametri geomorfometrici suggeriscono l’importanza di una caratterizzazione basata su parametri differenti della per le diverse tipologie di frana. Ad esempio, per la propensione al ribaltamento risulta poco efficace la relazione tra il deposito di frana così prodotto e il substrato su cui poggia, elemento che è sicuramente più significativo per le frane di scivolamento. L’approccio geologico inteso in senso classico è stato affiancato dal contributo fornito dalla Geomatica per poter analizzare congiuntamente dati digitali nativi (per esempio, modelli di elevazione del terreno ed elaborazioni derivate). Il risultato atteso è ottenere una caratterizzazione geomorfologica dei bacini della Sardegna in funzione delle diverse tipologie di fenomeni franosi

Fanconi anemia manifesting as a squamous cell carcinoma of the hard palate: a case report

Fanconi Anemia is a rare autosomal recessive disorder characterized by various congenital malformations, progressive bone marrow failure at a very young age and of solid tumors development. The authors present a rare case of a squamous cell carcinoma of the hard palate in a Fanconi Anaemia patient. The atypical clinical manifestation rendered the diagnosis more difficult. This case, for age of appearance, sex and localization, is unique in international literature. We recommend a quarterly follow up of the oral-rhino-pharynx complex in FA patients and to consider as carcinomas, all oral lesions that last more than two weeks

Navigation System Approach in Zygomatic Implant Technique

ABSTRACT: In some patients, the resolution of severe maxillary atrophies can be hardly achieved without the use of zygomatic implants. Although many scientific studies have already demonstrated the excellent immediate stability in long term, the use of zygomatic implants is not yet widespread. Among the complications of this technique, the most threatening is the risk of damaging the eyeball or the maxillary nerve.The use of the navigator system as a surgical aid for implant placement allows to control, at any time, the position of the drill in the bone, avoiding any injury to ocular and nervous structures. The authors present a clinical report which shows a patient affected by a very severe form of post-traumatic maxillary atrophy that has been solved through the of zygomatic implants placement using the “Implant Bone Navigation” system. This procedure allows both to cut down the risks on ocular and nervous structures of the maxilla and also to reach excellent rehabilitation results in such severely compromised patients

Alveolar ridge split technique using piezosurgery with specially designed tips

The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques introduced for the expansion of alveolar ridges with a horizontal bone deficit is the alveolar ridge split technique. The aim of this article is to give a description of some new tips that have been specifically designed for the treatment of atrophic ridges with transversal bone deficit. A two-step piezosurgical split technique is also described, based on specific osteotomies of the vestibular cortex and the use of a mandibular ramus graft as interpositional graft. A total of 15 patients were treated with the proposed new tips by our department. All the expanded areas were successful in providing an adequate width and height to insert implants according to the prosthetic plan and the proposed tips allowed obtaining the most from the alveolar ridge split technique and piezosurgery. These tips have made alveolar ridge split technique simple, safe, and effective for the treatment of horizontal and vertical bone defects. Furthermore the proposed piezosurgical split technique allows obtaining horizontal and vertical bone augmentation

Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea

Rationale. The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. Objectives. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients. Methods. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. Measurements and Main Results. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 ( < 0.01). The area under the ROC curve (95% CI) was the parameter to evaluate the accuracy of the OAAT: it was 0.91 (0.81-1.00) for the diagnosis of OSA (AHI ≥ 5), 0.90 (0.82-0.98) for moderate OSA (AHI ≥ 15), and 0.84 (0.76-0.92) for severe OSA (AHI ≥ 30). Conclusions. The OAAT has shown a high correlation with polysomnography and also a high diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed