Osteonecrosis of the jaws in patients treated with bisphosphonates.

The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011.

Dermal melanocytosis of the scalp associated to intracranial melanoma: malignant blue nevus, neurocutaneous melanosis, or neurocristic cutaneous hamartoma?

Intracranial invasion of cellular blue nevus is extremely rare, and its malignant transformation is even less common. The differential diagnosis includes neurocutaneous melanosis and neurocristic cutaneous hamartoma. A 50-year-old female presented with intracranial melanoma in contiguity with a congenital blue nevus on the scalp.

The safety of magnetic resonance imaging in patients with programmable implanted intrathecal drug delivery systems: a 3-year prospective study.

Background: It is common clinical practice to perform magnetic resonance imaging (MRI) in patients with indwelling programmable intrathecal drug delivery (IDD) systems, although the safety of the procedure has never been documented. We performed a single-center, 3-year, prospective evaluation in patients with a programmable implanted IDD to assess patient discomfort, IDD technical failures, and adverse effects during and after exposure to MRI.

Methods: Forty-three consecutive patients with an implanted programmable IDD system (SynchroMed® EL Implantable Infusion Pump, Model 8626L-18, and SynchroMed® II Model 8637-20, 8637-40; Medtronic, Inc.

The acromion thoracic flap: a reconstructive resource after exeresis of a parotid fibrosarcoma.

Sarcomas are rather uncommon in the salivary glands and have a high tendency towards recurrence. The treatment of choice is surgery, with the first surgical procedure being crucial, as the small size of the tumor is accompanied by the absence of post-surgery and post-radiotherapy fibrosis, which facilitates the surgery. The evident tendency towards recurrence makes it advisable to be radical in the exeresis.

Erythema multiforme: diagnosis, clinical manifestations and treatment in a retrospective study of 22 patients.

Background: Erythema multiforme (EM) is an acute disorder of the skin and mucosal membranes manifesting in the oral cavity (60-70% of all patients) as polymorphic erosive, ampullar, and bloodstained crusts. The etiology is unclear, although an autoimmune mechanism is involved. Infections and drugs have been implicated in the etiopathogenesis.

Changes in smoking habit among patients with a history of oral squamous cell carcinoma (OSCC).

Objective: To determine the changes in smoking habit among patients with oral squamous cell carcinoma (OSCC) diagnosed and treated in the Service of Stomatology (Valencia University General Hospital. Valencia, Spain).

Material And Methods: The study involved 123 patients with a history of OSCC interviewed by telephone on their smoking habits at the time of the diagnosis and modifications in habits subsequently.

Ultrasound-guided transversus abdominis plane block for spinal infusion and neurostimulation implantation in two patients with chronic pain.

Objective: This case report describes an ultrasound approach to the transversus abdominis plane (TAP) local anesthetic block. This block induces sensory blockade in the lower half of the abdomen where the pulse generator or the infusion pump is to be housed in a subcutaneous pocket, and therefore provides an alternate to general anesthesia or administration of high-dose local anesthetics.

Case Report: We report two cases of neuromodulation procedures-implantation of an internal morphine pump for severe somatic pain refractory to other therapies and placement of a double-stimulator generator for dorsal column stimulation in a patient diagnosed with postoperative failed-back syndrome.

Egg white specific IgE levels in serum as clinical reactivity predictors in the course of egg allergy follow-up.

It is thought that the natural evolution of egg allergy has a good tolerance prognosis. However, there are few follow-up studies that determine the exact probability of tolerance. The aim of this study was to determine the likelihood that children younger than 2,5 years of age with allergy to egg would eventually have tolerance to it and to analyze if monitoring egg white-specific IgE level over time could be used as a predictor for determining when patients develop clinical tolerance.

Eosinophil degranulation patterns in nasal polyposis: an ultrastructural study.

Background: Eosinophils are possibly the most important inflammatory cells in the pathogenesis of rhinosinusitis with nasal polyposis. Eosinophil degranulation is the mechanism by which these cells exert their inflammatory action. Knowledge of eosinophil state and degranulation mode therefore may help us to better understand this disease.

Retinoids and proliferative verrucous leukoplakia (PVL). A preliminary study.

Objective: A study is made of the efficacy and adverse effects of retinoid therapy applied to the white lesions of proliferative verrucous leukoplakia (PVL).

Material And Methods: The results of retinoid therapy were evaluated in 17 patients diagnosed with PVL. Topical retinoids were used in 5 patients, in the form of two daily applications of 0.

Foreign body granulomatous reactions to cosmetic fillers: a clinical study of 15 cases.

Introduction: Subcutaneous or submucosal infiltration of cosmetic materials is a very common practice, because of the ease with which such materials can be deposited, and their presumed innocuousness. However, in recent years there have been reports of foreign body granulomatous reactions occurring many years after infiltration.

Method: Data were collected on the clinical manifestations, histopathological findings, treatment, and course of the lesions of 15 patients.

Comparative study on chronic tissue damage after cordectomies using either CO2 laser or microdissection electrodes.

Background: This study compared the chronic damage to laryngeal soft tissues produced by microdissection electrodes and a CO(2) laser after cordectomies.

Methods: We included patients who were operated on to treat T1 glottic carcinomas and needed a second laryngeal surgery. We examined specimens from 6 patients each operated on with a CO(2) laser or microdissection electrodes.

Pathological examination of cordectomy specimens: analysis of negative resection.

Objective: Occasionally, after performing a cordectomy to treat a T1 glottic tumor, the pathologist does not detect carcinomatous cells in the surgical specimen. This study determined how often this happens and analyzed these cases to identify related variables.

Methods: Forty-six patients were studied.

Effect of total nasal obstruction on nocturnal oxygen saturation.

Background: Nasal obstruction is considered a risk factor for sleep-disordered breathing (SDB), although the relationship has not been established clearly. This study explores the repercussion of total nasal packing on arterial oxygen saturation during the nocturnal resting hours and its implication in SDB.

Methods: Forty patients were subjected to total nasal packing after nasal surgery or epistaxis.

Bacteremia originating in the oral cavity. A review.

In patients at risk because of heart disease, bacteremias induced by invasive dental treatments have been reported as a cause of bacterial endocarditis (BE) - a serious disorder that continues to involve a high mortality. As a result, different scientific societies have supported recommendations for the administration of antibiotics prior to invasive dental treatments, in order to neutralize bacteremia. In this context, the recommendations of the American Heart Association (AHA) are the most widely used in our setting.

Mental neuropathy as a manifestation associated with malignant processes: its significance in relation to patient survival.

Purpose: Mental neuropathy (MN) is characterized by the presence of a sensory defect in the form of paresthesias or dysesthesias in the territory innervated by the mental nerve. MN may be the first manifestation of systemic cancer, a symptom of spread of an established tumor, or a sign of infiltration in an intraoral lesion. In any of these cases, the symptom is indicative of a very poor patient prognosis.

Malignant fibrohistiocytoma of the parotid region. Report of a case.

Most salivary gland tumors are benign, malignant lesions accounting for 15-30% of the total. The most frequent site of salivary gland neoplasms is the parotid gland (80% of all cases). We present a case of malignant fibrohistiocytoma with atypical features due to its location (in the parotid region), size and rapid growth.

Flap repositioning versus conventional suturing in third molar surgery.

Objectives: A comparative study is made of two types of flaps in semi-impacted third molar surgery and their relation to the postoperative period (pain, swelling and trismus).

Material And Methods: Twenty-five healthy patients were subjected to surgical extraction of both semi-impacted lower third molars, located in a similar clinical and radiographic position. In 25 cases the wound was sutured using a reflection flap (healing by first intention), while in the 25 contralateral cases the conventional technique was used (simple approximation of the wound margins).

A review of temporomandibular joint disease (TMJD). Part II: Clinical and radiological semiology. Morbidity processes.

The clinical signs and symptoms of greatest semiologic value in temporomandibular joint disease (TMJD) are muscle pain, joint pain, limitations in mandibular movement, and joint sounds. Imaging studies of the joint are very useful for establishing the diagnosis and for discarding other disease processes, though in many cases diagnostic error results from the detection of a large proportion of patients with alterations in the imaging studies but with no associated clinical manifestations. Panoramic X-rays and magnetic resonance imaging are the most commonly used complementary techniques for diagnosing TMJD.

Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors.

Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used.

Antibiotic use in dental practice. A review.

Antibiotics are commonly used in dental practice. It has been estimated that 10% of all antibiotic prescriptions are related with dental infections. The association amoxicillin-clavulanate was the drug most frequently prescribed by dentists during 2005, at least in the Valencian Community (Spain).

Magnetic resonance imaging in patients with spinal neurostimulation systems.

Background: The safety of performing magnetic resonance imaging (MRI) in patients with spinal cord stimulation (SCS) systems needs to be documented. A prospective in vivo study in patients with SCS, exploring the changes produced by MRI and the associated side effects, was performed.

Methods: After ethics committee approval and patient consent, 31 consecutive patients with SCS at different spinal levels requiring a scheduled MRI evaluation were studied during an 18-month period.