[Stomatologic oncology: recent findings].
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Biomedical subjects
Publications and source records attributed to M D Mignogna.
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A double-blind versus placebo clinical study has been carried out in order to assess the antiinflammatory and analgesic activity of nimesulide suppositories in pain-inflammatory pathologies of odontostomatological nature. Forty-four patients aged between 18 and 62 were recruited for the purpose and assigned at random to treatment with nimesulide or placebo for a minimum period of 3 days. Treatment with nimesulide reduced both the pain and the tumefaction due to the inflammatory pathology more rapidly and, by the 3rd day of treatment led to complete remission of the symptomatology. Tolerability of nimesulide was excellent.
The paper reviews the literature on oral modifications presented by subjects affected by beta-thalassemia, an hereditary hemopathy present in significant numbers in some areas of Italy. Following a description of the clinical characteristics of the disease, the paper focuses on the genetic alterations leading to the hemopathy and their implication in the onset of the thalassemic state.
The Authors, after a short description of the anatomy of the root canal, deal with the aetiological factors of the periapical pathology, acute and chronic. They examine the pathogenetic mechanisms of acute flogistic process of the periapical tissue and consider the principal mediators involved in the tissue lesion.
The Authors describe the aetiological mechanisms of periapical diseases. They deal with immunologic reactions in inflammation with particular features on the lymphocytic and macrophagic products and their role in the periapical reactions. Furthermore, they describe the pathogenesis of bone resorption, a common evolution of the chronic periapical disease.
The paper reports the findings of a study of 46 subjects affected by beta-thalassemia major who underwent periodic transfusion therapy. A reduced incidence of the caries process was observed, above all in subjects treated from the first months of life. After a short review of the main problems posed by these patients during dental treatment, the Authors propose a course of preventive antibiotic treatment to be carried out before the start of dental work.
A rare case of a primary malignant melanoma of the upper alveolus with rapid spread to the cervical lymph nodes and brain in a 47-year-old man is described.
Numerous systemic syndromes with different aetiopathogenetic and clinical features are constantly accompanied by functional changes in polymorphonucleated neutrophils and, particularly, in their chemotactic properties. The function they perform, namely impeding invasion of the organism by external aggressive factors, cannot therefore be implemented. These patients are thus abnormally susceptible to infections and present a high frequency of serious periodontal disease.
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The literature on the subject is reviewed, special attention being paid to the complex problems of aetiological and pathogenetic classification involved by such lesions in the oral cavity. Stress in salso laid on topographical and histological aspects of pigmented lesions of melanocytic origin.
A clinical case of focal dermal hypoplasia or Goltz syndrome is described with details of the odontostomatological features both generally encountered and observed in the present case. The main aetiopathogenic hypotheses are also discussed and a dominant X-linked transmission is postulated.
The aetiopathogenetic and evolutive problem of primary oral melanoma is examined with particular regard for melanosis and its relationship with oral naevi. These lesions are classified differently by Authors with different opinions regarding their ability to turn malignant. In this regard, the latest and most reliable hypotheses on the subject are put forward.
After reporting some statistics, the procedures used in the dental treatment of the heart surgery patients subjected to anticlotting pharmacological treatment are described. Considering the considerable difficult in implementing the necessary pharmacological modifications and the high percentage of possible complications involved in these procedures, maximum interdisciplinary cooperation is recommended with heart surgery colleagues so as to carry out dental treatment in good time in patients who are candidates for heart and large vessel operations.
Following a short review of the main aetiopathogenetic theories on dental agenesia, a personal statistical study of this pathology is reported. 1529 orthopantomographs of juveniles aged between 7 and 14 were examined. 79 cases of hypodentia were observed (5.2%), 32 in males (4.05%) and 47 in females (6.78%). The most interesting tooth was the second premolar with an incidence of 58.9% followed by the lateral incisor, with an incidence of 26.38%. This is in agreement with the international literature.
The biological causes of edentulous alveolar crest reabsorption are examined in the light of recent discoveries on the physiopathology of bone metabolism. The main techniques used for the classification of patients in terms of bone metabolism type are then described and the question of whether any currently available pharmacological treatment is capable of preparing for, supporting, preserving or even effectively replacing preprosthetic surgery is posed.
A case of ameloblastoma located at the upper maxillary, a site that is rare according to the literature, is reported. A perfect cure was obtained with conservative treatment without recurrence, as is shown by the four-year follow-up.
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