Chirurgia delle lesioni dei tessuti molli del cavo orale: diagnosi differenziale con le neoformazioni maligne

Many benign lesions can arise from oral soft tissues: they are inflammatory lesions like pyogenic granuloma or papillary hyperplasia and benign neoplasms as minor salivary gland adenoma or nodular fasciitis. All of these lesions have similar clinical presentation: they usually present as painless mass of the oral soft tissues associated with overlying skin and oral mucosa that are intact; in other cases the lesions involve the oral mucosa that can be ulcerated and bleeding. The differential diagnosis of all of these lesions among them and with malignant primitive and metastatic tumours can be very difficult because of their clinical presentation and instrumental examinations that are often equivalent. In this research project the author has evaluated and followed 63 patients that presented to the Maxillo-Facial Unit of the University of Sassari in the period fom 2006 until 2008 with benign lesions of the oral soft tissues. The most frequent lesion was the squamous papilloma, then in descending order the patients presented benign histiocytoma, pyogenic granuloma, minor salivary gland adenoma, peripherical ossifying fibroma, solitary fibrousus tumour and oral mucinosis. The author has demonstrated that the histologic examination of a preoperative biopsy or of the entire lesion, if its dimension are less than 2 cm, is the only possibility to make the right diagnosis and to decide the correct treatment

Recommendations for a safe restart of elective aerosol-generating oral surgery procedures following the COVID-19 pandemic outbreak: An Italian multicenter study

Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed

The Impact of the COVID-19 Pandemic on Women's Perinatal Mental Health: Preliminary Data on the Risk of Perinatal Depression/Anxiety from a National Survey in Italy

Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18-52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women's mental health programs

Three-dimensional primary reconstruction of anterior mouth floor and ventral tongue using the 'trilobed' buccinator myomucosal island flap

Three-dimensional reconstruction of the anterior mouth floor and ventral tongue after ablative surgery can be achieved using several techniques. The ideal reconstruction should be accomplished with the same or similar type of tissue, and cheek axial myomucosal flaps based on the branches of facial or internal maxillary arteries seem ideal for this purpose. From March 2005 to May 2007, 23 patients underwent cheek axial myomucosal flap reconstruction after oral cancer surgical ablation. Thanks to their thinness and pliability, these flaps were frequently shaped to obtain an accurate reconstruction. According to Whetzel’s hypothesis, an intraoral flap designed to include the axial vessel of one area can safely carry the mucosa of a neighbouring vascular area. The authors describe a large buccinator myomucosal island flap based on the branches of the facial artery and formed in a trilobed shape in order to capture the adjacent buccal mucosal angiosome from the internal maxillary artery. The flap provided the correct anatomical oral reconstruction for the anterior mouth floor and ventral tongue. The function of the tongue, oral intake and mastication were not impaired. The trilobed buccinator myomucosal island flap is a suitable option for the three-dimensional reconstruction of the anterior mouth floor and ventral tongue

Trophic flexibility of the Atlantic blue crab Callinectes sapidus in invaded coastal systems of the Apulia region (SE Italy): A stable isotope analysis

The Atlantic blue crab Callinectes sapidus is recognized as an Invasive Alien Species in the Mediterranean Sea. However, its trophic role and feeding flexibility in invaded benthic food webs have been addressed only recently. Here, field samplings were conducted in winter and summer in five coastal systems of the Apulia region (SE Italy), three located on the Ionian Sea (Mar Piccolo, Torre Colimena, and Spunderati) and two on the Adriatic Sea (Acquatina and Alimini Grande). Captured blue crabs were weighed and had their δ13C and δ15N isotopic signatures measured; their trophic level (TL) was estimated using the mussel Mytilus galloprovincialis as isotopic baseline. C. sapidus abundances varied greatly across systems and seasons, and in Adriatic systems the species was not collected in winter. Trophic levels showed significant spatial and temporal variations, although with no general pattern. In winter, the Mar Piccolo population showed the highest TL values; the lowest estimates were in Torre Colimena and Spunderati, where crabs showed δ13C signatures significantly higher than mussels, suggesting the contribution of13C-enriched plant material in the diet. In summer, with the exception of the Mar Piccolo, Ionian populations increased their trophic level; both Adriatic populations were characterized by the lowest TL estimates. The analysis performed at the individual scale further indicated body weight-related changes in trophic level. For the Torre Colimena population, in particular, a hump-shaped pattern was observed in both seasons. The present study highlighted a considerable spatial and temporal trophic flexibility of C. sapidus at the population scale, while at the individual scale size-related shifts in trophic level were observed. The ability of the blue crab to vary its energy sources in relation with season, local environmental conditions, and ontogenetic stage is emphasized, suggesting that it may represent a key determinant of its invasion success

Delayed iliac abscess as an unusual complication of an iliac bone graft in an crthognathic case

Abstract. The reconstruction of large maxillofacial defects generally requires harvesting bone from extra-oral sites. The main source of autogenous bone is the iliac crest. This donor site is used to obtain bone for augmentation in orthopaedic surgery, neurosurgery, and oral and maxillofacial surgery, where the main indications are secondary and tertiary osteoplasty in patients with cleft-lip and palate, reconstruction of bony defects after operations for tumours, and augmentation of severe atrophy of the alveolar crest in preprosthetic surgery. A review of the literature on complications following bone harvesting from the anterior iliac crest reveals persistent pain, nerve injury, haemorrhage, limping, persistent gait abnormalities, conspicuous scarring, bone contour alteration, infection, fracture, meralgia paraesthetica, peritonitis, and herniation. The authors report an unusual complication: a huge iliac abscess that appeared 4 years after bimaxillary surgery involving iliac bone grafts

The cheek: donor site with many reconstructive alternatives

Three-dimensional reconstruction of medium-size defects of oral cavity after oncologic ablative surgery or traumatic lesions, is a difficult aim. Since the ‘ideal reconstruction’ should be accomplished with same or similar kind of tissue, we think that cheek myo-mucosal flaps based on the branches of facial or internal maxillary arteries can better provide for this purpose

Complications and post-operative sequelae of temporomandibular joint arthrocentesis

Objective: To evaluate intraoperative complications and postsurgical sequelae associated with arthrocentesis of the TMJ, including injection of Sodium Hyaluronate. Methods: This retrospective study evaluated 433 arthrocentesis procedures performed in 315 patients between January 2009 and August 2016. The authors reviewed the complications identified during the procedure and the follow-up period. Results: Temporary swelling of the periarticular tissues (95.1%) or the external auditory canal (23.5%), ipsilateral temporary open bite (68.8%), frontalis and orbicularis oculis paresis (65.1%), preauricular hematoma (0.4%), and a case of vertigo (0.2%) were the complications detected. Conclusions: TMJ arthrocentesis remains a procedure with a minimum number of important complications. If present, complications are generally temporary, caused by the anesthetic effect or by the soft tissue edema created by the fluid extravasation created by the irrigation procedure, and can be managed on an outpatient basis