Relationship between oral cancer and implants: clinical cases and systematic literature review

The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or peri-implantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC). Objectives: To review the literature of cases that associate implant placement with the development of oral cancer. Study design: We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. Results: We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. Conclusions: Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC.

Late mesozoic to neogene radiolarian biostratigraphy and palaeoceanography in the Caribbean and East pacific region

^Raduolarians constitute a good tool for contributing to the biostratigraphy of accreted terranes and in deep-sea sediment sequences. The use of radiolarians is also proven to be valuable as a palaeoceanographic indicator. The present study evaluates radiolarians in three different geological settings, in order to better constrain the age of the sites and to try to understand their palaeoenvironmental situation at different periods, particularly in the Caribbean-Central America area. On the Jarabacoa Block, in Central Dominican Republic, a hundred meters of siliceous mudstones (Pedro Brand section in the Tireo Group) was dated as Turonian- Coniancian in age using radiolarians. A 40Ar-39Ar whole rock age of 75.1±1.1 Ma (Campanian), obtained in a basalt dyke crosscutting the radiolarian bearing rocks, a consistent minimum age for the pelagic-hemipelagic Pedro Brand section. The Jarabacoa Block is considered as the most complete outcrop section of Pacific ocean crust overlain by a first Aptian-Albian phase of Caribbean Large Igneous Province-type activity (CLIP), followed by the development of a Cenomanian-Santonian intraoceanic arc, which is in turn overlain by a late Campanian-Maastrichtian CLIP-phase. The Tireo Group records an episode of pelagic to hemi-pelagic and intermediate to acidic arc-derived sedimentation, previous to the youngest magmatic phase of the CLIP. Thus, the section of Pedro Brand has been interpreted in this study as being part of the intraoceanic arc. In northern Venezuela, a greenish radiolarite section from Siquisique Ophiolite (basalts, gabbros and some associated cherts) in Guaparo Creek has been studied. In previous studies, the Ophiolite unit (Petacas Creek section) has been dated as Bajocian-Bathonian, based on ammonites present in interpillow sediments from basalt blocks. New dating of the present study concluded in an Aptian?-Albian-Cenomanian age for the Guaparo creek section (middle Cretaceous), based on radiolarian assemblage associated to basalts-gabbros rocks of the unit. Previous plagioclase 40Ar-39Ar ages from the Siquisuique Ophiolite may be slightly younger (94-90 Ma.) and may, therefore, represent younger dykes that intruded onto a well-developed sheeted dyke complex of the Siquisique. The geochemistry of these rocks and the palaeotectonic reconstruction of the Caribbean area during this period suggest that these rocks were derived from a mid-ocean ridge with an influence of deep mantle plume. The Siquisique Ophiolite most probably represents a fragment of the proto-Caribbean basin. The Integrated Ocean Drilling Program Expedition 344 drilled a transect across the convergent margin off Costa Rica. Two sites of this expedition were chosen for radiolarian biostratigraphy and palaeoceanographic studies. Both sites (U1381C and U1414A) are located in the incoming Cocos plate, in the eastern Equatorial Pacific. The succession of U1381C yields a Middle Miocene to Pleistocene age, and presents an important hiatus of approximately 10 Ma. The core of U1414A exposes a continuous sequence that deposited during Late Miocene to Pleistocene (radiolarian zones RN6-RN16). The ages were assigned based on radiolarians and correlated with nannofossil zonation and tephra 40Ar-39Ar datation. With those results, and considering the northward movement of the Cocos plate motion (about 7 cm/year), deduction is made that the sites U1381C and U1414A were initially deposited during the Miocene, several hundreds of kilometres from the current location, slightly south of the Equator. This suggests that the faunas of these sites have been subjected to different currents, first influenced by the cold tongue of the South Equatorial Current and followed by the warm Equatorial Countercurrent. At last, coastal upwelling influenced faunas of the Pleistocene. -- Les radiolaires sont considérés comme un outil utile à la biostratigraphie des terrains accrétés et des sédiments profonds. Leur utilité est aussi prouvée comme étant remarquable au niveau des reconstructions paléocéanographiques. La présente étude évalue l'importance et la présence des radiolaires de trois localités géologiquement différentes d'Amérique Centrale-Caraïbes, dans le but d'améliorer les model d'âges et de mieux comprendre la situation paléoenvironnementale à travers le temps. Dans le Bloque de Jarabacoa, au centre de la République Dominicaine, une section de cent mètres (section de Pedro Brand, Groupe de Tireo) a été datée comme faisant partie du Turonien-Santonien, en utilisant les radiolaires. Une datation 40Ar-39Ar sur roche totale de 75±1.1 Ma (Campanien) a été obtenu pour vin dyke traversant les sédiments riches en radiolaires, en cohérence avec l'âge minimum accordé à la section de Pedro Brand. Aux Caraïbes, le Bloque de Jarabacoa est considéré comme l'affleurement le plus complet présentant une succession de croûte océanique d'origine Pacifique recouverte d'une première phase d'activité volcanique de type CLIP (Caribbean Large Igneous Province) d'âge Aptien- Albien, de dépôts d'arc volcanique intra-océanique d'âge Cénomanien-Santonien, puis d'une seconde phase de type CLIP d'âge Campanien-Maastrichtien. Le Groupe de Tireo enregistre un épisode de dépôt pélagiques-hémipélagiques et d'arc volcanique, antérieur à la plus jeune phase de type CLIP. Cette étude place donc la formation de la section de Pedro Brand au moment du développement de l'arc intra-océanique. A Guaparo Creek (nord du Vénézuela), une section de radiolarite verdâtre faisant partie des ophiolites de Siquisique (basaltes, gabbros, cherts) a été étudiée. Dans des études précédentes, sur la localité de Petacas Creek, l'unité ophiolitique a été daté d'âge Bajocien- Bathonien (Jurassique) sur la base d'ammonites trouvées dans des sédiments intercalés entre des laves en coussins. Les nouvelles datations de notre étude, basées sur des assemblages à radiolaires de l'unité à basaltes-gabbros, donnent un âge Aptien?-Albien-Cénomanien (Crétacé moyen). Les âges de l'Ophiolite de Siquisique, précédement calculés par la méthode sur plagioclases, pourraient être légèrement plus jeune (94-90 Ma) et donc représenter des intrusions plus récentes de dykes dans le complexe filonien déjà bien dévelopé. La géochimie de ces roches magmatiques, ainsi que les reconstructions paléotectoniques de la zone Caraïbes durant cette période, suggèrent que ces formations sont dérivées d'une ride médio-océanique associée à l'influence d'un panache mantellique. L'ophiolite de Siquisique représente très probablement un fragment du bassin de proto¬Caraïbe. L'expédition 344 du programme IODP (Integrated Ocean Drilling Program) a eu lieu dans l'optique de forer et dresser une coupe de la marge convergente au large du Costa Rica. Deux sites de cette expédition ont été choisis pour les besoins des études de biostratigraphie et de reconstruction paléocéanographique. Ces deux sites (U1381C et U1414A) sont situés sur la plaque subductante de Cocos, dans la zone Pacifique est-équatoriale. La carotte U1381C expose une séquence s'étalant du Miocène moyen au Pléistocène, et présente un important hiatus d'environ 10 Ma. La carotte U1414A expose une séquence continue s'étalant du Miocène tardif au Pléistocène (zone à radiolaires RN6-RN16). Les âges ont été assignés sur la base des radiolaires et corrélés avec les zones à nanofossiles et les datations 40Ar-39Ar sur téphras. Avec ces résultats, et en considérant le mouvement nord de la plaque de Cocos (environ 7 cm/an), déduction est faite que les deux sites étaient initialement situés, au cours du Miocène, à plusieurs centaines de kilomètres de leur location actuelle, au sud de l'équateur. Cela suggère que les faunes de ces sites ont été sujettes à différents courants; premièrement influencées par la langue froide du SEC (South Equatorial Current), puis par les eaux chaudes du ECC (Equatorial Countercurrent). Pour terminer, les remontées d'eau côtières ont influencées les faunes Pléistocène.

Spectrum of digoxin-induced ocular toxicity: a case report and literature review.

BACKGROUND: Digoxin intoxication results in predominantly digestive, cardiac and neurological symptoms. This case is outstanding in that the intoxication occurred in a nonagenarian and induced severe, extensively documented visual symptoms as well as dysphagia and proprioceptive illusions. Moreover, it went undiagnosed for a whole month despite close medical follow-up, illustrating the difficulty in recognizing drug-induced effects in a polymorbid patient. CASE PRESENTATION: Digoxin 0.25 mg qd for atrial fibrillation was prescribed to a 91-year-old woman with an estimated creatinine clearance of 18 ml/min. Over the following 2-3 weeks she developed nausea, vomiting and dysphagia, snowy and blurry vision, photopsia, dyschromatopsia, aggravated pre-existing formed visual hallucinations and proprioceptive illusions. She saw her family doctor twice and visited the eye clinic once until, 1 month after starting digoxin, she was admitted to the emergency room. Intoxication was confirmed by a serum digoxin level of 5.7 ng/ml (reference range 0.8-2 ng/ml). After stopping digoxin, general symptoms resolved in a few days, but visual complaints persisted. Examination by the ophthalmologist revealed decreased visual acuity in both eyes, 4/10 in the right eye (OD) and 5/10 in the left eye (OS), decreased color vision as demonstrated by a score of 1/13 in both eyes (OU) on Ishihara pseudoisochromatic plates, OS cataract, and dry age-related macular degeneration (ARMD). Computerized static perimetry showed non-specific diffuse alterations suggestive of either bilateral retinopathy or optic neuropathy. Full-field electroretinography (ERG) disclosed moderate diffuse rod and cone dysfunction and multifocal ERG revealed central loss of function OU. Visual symptoms progressively improved over the next 2 months, but multifocal ERG did not. The patient was finally discharged home after a 5 week hospital stay. CONCLUSION: This case is a reminder of a complication of digoxin treatment to be considered by any treating physician. If digoxin is prescribed in a vulnerable patient, close monitoring is mandatory. In general, when facing a new health problem in a polymorbid patient, it is crucial to elicit a complete history, with all recent drug changes and detailed complaints, and to include a drug adverse reaction in the differential diagnosis.

Diagonal ear lobe crease and atherosclerosis: a review of the medical literature and dental implications

In Spain a significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodromal symptoms. The diagonal ear lobe crease (DELC) has been characterized in the medical literature as a surrogate marker which can identify high risk patients having occult atherosclerosis. This topic however has not been examined in either the medical or dental literature emanating from Spain. The majority of clinical, angiography and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. A minority of studies have however failed to support this hypothesis. More recently reports using B mode ultrasound have also linked DELC to atherosclerosis of the carotid artery and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. DELC is readily visible during head and neck cancer screening examinations. In conjunction with the patient"s medical history, vital signs, and panoramic radiograph, the DELC may assist in atherosclerotic risk assessment

Fragile X-syndrome: literature review and report of two cases

Fragile X-syndrome is caused by a mutation in chromosome X. It is one of the most frequent causes of learning disability. The most frequent manifestations of fragile X-syndrome are learning disability, different orofacial morphological alterations and an increase in testicle size. The disease is associated with cardiac malformations, joint hyperextension and behavioural alterations. We present two male patients aged 17 and 10 years, treated in our Service due to severe gingivitis. Both showed the typical facial and dental characteristics of the syndrome. In addition, we detected the presence of root anomalies such as taurodontism and root bifurcation, which had not been associated with fragile X-syndrome in the literature. In some cases these root malformations have been associated with other sex-linked congenital syndromes, though in none of the studies published in the literature have they been related with fragile X-syndrome. This syndrome is relevant due to its high prevalence, the presentation of certain oral and facial characteristics that can facilitate the diagnosis, and the few cases published to date

Translations and Translators of English-language Literature in Catalan Literary Publications and Series between 1868 and 1910

Translations into Catalan of English and American authors during the final quarter of the nineteenth century are few and far between. Numerically, English-language literature most likely ranks fifth or sixth among all the translations of this period. We take inventory here of translations found in Catalan magazines from this time (the oldest dates from 1868) and in published series that came out at this time (if these continued until later, we trace them up to their final year). At the same time, the translators are examined, including reference, where available, as to whether the translations are direct or indirect. Finally, we consider some possible causes for the low English-language volume in Catalan translation during the period.

Ocular adnexal (orbital) solitary fibrous tumor: nuclear STAT6 expression and literature review.

PURPOSE: To report the clinico-pathological features of solitary fibrous tumor occurring in the ocular adnexa (OA) in a single center. To assess the presence of NAB2-STAT6 genes fusion in OA solitary fibrous tumor detected by nuclear overexpression of STAT6. METHODS: Retrospective study including orbital and OA solitary fibrous tumors treated between 2006 and 2014 in our center. The clinical, radiological, and histopathological findings were evaluated. STAT6 expression was assessed by immunohistochemistry. RESULTS: Five patients were identified and presented with a chronic OA mass. The tumors were radiologically well delimited, highly vascularized and without bone erosion. All the patients underwent complete surgical excision. Pathological examination confirmed solitary fibrous tumor in all cases. All tumors demonstrated a nuclear expression of STAT6. There were no recurrences, with a mean follow-up of 5 years after surgery. Our review demonstrated that proptosis was the most common presentation occurring in 60 % of the cases. In the ocular adnexa, adverse histological criteria were found in 19.7 % of the tumors, and recurrences were observed in 48 % of these cases. Thirty-six percent of patients presented at least one local recurrence, and metastastic spread was found in 2.4 % of the cases. Tumor-related death was described in two cases. CONCLUSION: Ocular adnexal SFT are rare and usually present as a chronic orbital mass with proptosis. In the OA, solitary fibrous tumor demonstrates STAT6 nuclear expression, as documented in other locations. Recurrences are unusual and metastasis exceptional. Initial surgical resection should be complete in order to avoid recurrence.

Management of severe blunt hepatic injury in the era of computed tomography and transarterial embolization: A systematic review and critical appraisal of the literature.

BACKGROUND: During the last decade, the management of blunt hepatic injury has considerably changed. Three options are available as follows: nonoperative management (NOM), transarterial embolization (TAE), and surgery. We aimed to evaluate in a systematic review the current practice and outcomes in the management of Grade III to V blunt hepatic injury. METHOD: The MEDLINE database was searched using PubMed to identify English-language citations published after 2000 using the key words blunt, hepatic injury, severe, and grade III to V in different combinations. Liver injury was graded according to the American Association for the Surgery of Trauma classification on computed tomography (CT). Primary outcome analyzed was success rate in intention to treat. Critical appraisal of the literature was performed using the validated National Institute for Health and Care Excellence "Quality Assessment for Case Series" system. RESULTS: Twelve articles were selected for critical appraisal (n = 4,946 patients). The median quality score of articles was 4 of 8 (range, 2-6). Overall, the median Injury Severity Score (ISS) at admission was 26 (range, 0.6-75). A median of 66% (range, 0-100%) of patients was managed with NOM, with a success rate of 94% (range, 86-100%). TAE was used in only 3% of cases (range, 0-72%) owing to contrast extravasation on CT with a success rate of 93% (range, 81-100%); however, 9% to 30% of patients required a laparotomy. Thirty-one percent (range, 17-100%) of patients were managed with surgery owing to hemodynamic instability in most cases, with 12% to 28% requiring secondary TAE to control recurrent hepatic bleeding. Mortality was 5% (range, 0-8%) after NOM and 51% (range, 30-68%) after surgery. CONCLUSION: NOM of Grade III to V blunt hepatic injury is the first treatment option to manage hemodynamically stable patients. TAE and surgery are considered in a highly selective group of patients with contrast extravasation on CT or shock at admission, respectively. Additional standardization of the reports is necessary to allow accurate comparisons of the various management strategies. LEVEL OF EVIDENCE: Systematic review, level IV.

Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

Aesthetic Breast Augmentation Mastopexy Followed by Post-surgical Pyoderma Gangrenosum (PSPG): Clinic, Treatment, and Review of the Literature.

INTRODUCTION: Pyoderma gangrenosum (PG) is a rare autoinflammatory neutrophilic ulcerative skin disease, often developing after a trauma or surgical wounds. In the literature there are several reports of post-surgical PG (PSPG) of the breast. The authors of this article experienced an impressive case of PSPG after an aesthetic breast augmentation mastopexy. PSPG is a rare but severe complication in this elective aesthetic surgical procedure. METHOD: A systematic review of the literature was performed, focusing on PSPG after aesthetic breast surgery (augmentation mammoplasty/mastopexy). The online databases Pubmed, Medline, and Cochrane were used and additionally a Google© search was conducted. We compared the data obtained from a systematic literature review to an index case of PSPG after esthetic augmentation mammoplasty. RESULTS: The literature search identified seven articles describing eight cases of PSPG after aesthetic breast surgery. In four of these cases augmentation mammoplasty had been carried out, in two cases mastopexy and in two cases augmentation mammoplasty and mastopexy (augmentation mastopexy). The patient we treated and describe in this paper underwent an augmentation mastopexy outside our clinic. Eight patients suffered from local disease, at the site of surgical wounds, one patient had disseminated disease. Leukocytosis was present in five cases (out of nine). Eight patients had received corticosteroid treatment, one patient refused such treatment. The duration of corticosteroid treatment was on average for 41 days (range 21-60 days). In all cases, the areola had been spared. Complete healing of PSPG was observed on average after 5 months (range 1.5 months-1 year). DISCUSSION: PSPG of the breast after aesthetic breast surgery is rare, but every plastic surgeon should consider this possibility, especially if skin disease develops post-surgery, mimicking wound infection that does not respond to broad-spectrum antibiotic treatment. CONCLUSION: Although the literature does not recommend this step, implant removal is recommended by the authors because bacterial wound infection normally cannot be ruled out definitely in the early stages of disease. Additional surgical intervention should be limited to the absolute necessary and performed only under adequate systemic immunosuppressive therapy. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .