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Recidiva di ameloblastoma al corpo mandibolare: ricostruzione e riabilitazione implantoprotesica
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Conservative treatment of unicystic mural ameloblastoma
Full text linkMural ameloblastoma is a subtype of Unicystic Ameloblastoma characterised by the expansion or infiltration of tumour nodules into the fibrous wall of the cyst. The behaviour of this subtype is highly aggressive, with a risk of recurrence comparable with that of Conventional Ameloblastoma. Consequently, the preferred treatment for Unicystic mural Ameloblastom is broad resection of the tumour. In this case report we describe the successful conservative treatment of a Unicystic mural Ameloblastom associated with an impacted tooth. The conservative treatment consinsted in a initial marsupialization followed by the enucleation of the lesion performed with a lateral corticotomy to create a “bone door” and the relocation of the “bone door” using microplates and titanium screws. Our conservative approach preserved the integrity of the inferior alveolar nerve as well as mandibular functionality and resulted in a good aesthetic outcome. Due to the behaviour of this lesion, a strict follow up is mandatory. In our experience, follow-up is conducted as long as possible regardless of the surgical treatment. This protocol includes Cone Beam CT performed 1 year after surgery and panoramic radiology (OPG) once a year until 5 years after surgery. OPG is then repeated every 3 years in patients with Unicystic Ameloblastoma and every 2 years in those with Conventional Ameloblastoma or ameloblastoma with mural invasion. Suspected recurrence should be evaluated by CBCT
Oral and cutaneous lichen planus correlate to primary sclerosing cholangitis: a case report
No full textAim. Lichen planus (LP) is a chronic inflammatory and immune-mediated disease with a mucosal and cutaneous involvement. The pathogenesis is characterized by T CD8+ and CD4+ mediated response against epithelial basal cells, leading to basal layer degeneration and sub-epithelial band like T-lymphocytes infiltration. The etiology is still unknown, but it is believed that many environmental agents can trigger the disease in genetically predisposed subjects. These agents include drugs, microbial and viral infections and contact sensitizers. In literature, cases of LP are reported in association with other autoimmune pathologies such as graft versus-host disease, lupus erythematous, primary biliary cirrhosis and Sjögren’s syndrome. The elevated risk of developing LP in patients with chronic hepatopathy, in particular those infected with HCV, has been documented but it is still controversially discussed. The concurrent presentation of primary sclerosing colangitis (PSC) and LP has been previously described in five cases: one nail lichen and four oral lichen planus (OLP).
Materials and Methods. A 67-year-old woman was referred to our clinic by her general dentist for evaluation of oral lesions associated with burning and pain symptoms. The patient reported the presence of a white-red painful fissured lesion, involving tongue and cheeks since 6 months. Fluctuating period of remission and worsening were described, strongly associated with spicy and acid food. Medical history was positive for primary sclerosing colangitis, diagnosed in 1997 and treated with angioplasty. In addition, the patient underwent excision of a pulmonary lobe for bronchial carcinoma and thyroidectomy for Hürthle cells adenoma. Drug history accounts for chronic intake of levothyroxine, potassium canreonate, ranitidine and torasemide. Widespread erythematous areas were highlighted during clinical examination, involving keratinized gingiva, lip vermilion, tongue dorsal mucosa and the buccal mucosa. Deep fissurations were present in the tongue dorsal mucosa, while the buccal mucosa showed the presence of reticular white lesion (Wickham's stripes). Moreover, a scaling erythematous dermatitis was appreciable in patient hands and legs skin with tendency to confluence and central atrophy. Scalp skin and hair follicles were also involved. The dermatitis appeared to be distributed predominantly in the photo-exposed areas. The patient referred the onset of these cutaneous manifestation since December 2008, firstly to hands and later to legs and back. Patient thus referred about a skin biopsy, which was not diagnostic for cutaneous lichen. An incisional biopsy of the buccal mucosa was performed.
Results. Histologic examination showed sections of malpighian mucosa with hyperkeratosis, acanthosis and vacuolization of the basal cell layer associated with the presence of necrotic keratinocytes (civatte bodies) and chronic infiammatory infiltration. The diagnosis of oral lichen planus was determined by the clinical and histological result. To date, the patient has refused to perform a new skin biopsy for diagnosis completion.
Discussion. The reported OLP case describes the common epidemiologic appearance. Average age of OLP onset is the 6th decade, lesion affects women and men with a ratio of 2:1. Clinically, characteristic features are present such as Wickham's striae, well- defined looping and intersecting white lines or striae on a background of minimal substantial erythema, and the typical course with period of remission and exacerbation. The buccal mucosa, the tongue, and the gingiva are the most often affected sites. Approximately two-thirds of patients experience discomfort even if the symptoms are very variable; in addition to a spontaneous manifestation, patients occasionally experience discomfort or pain only upon contact with spicy or acidic foods. Moreover, sense of mucosal roughness, reduced mucosal flexibility, and limited mouth opening are often reported.
Patient medical history is worthy of attention for PSC, a rare cholestatic liver disease characterized by concentric and obliterative fibrosis which evolves in stricturing and dilatation of the biliary tree. In the majority of cases, it will progress to cirrhosis. Men are more affected than women and the prevalence, although is rare, is increasing worldwide. Clinical manifestations are very different from the asymptomatic patient with an accidental diagnosis to jaundice and liver decompensation. Complications are common such as liver failure, hepatobiliary malignancy, bowel cancer and death. The pathogenesis is not well defined, but several mechanism have been proposed like immune signalling dysregulation, increased liver toxins level due to bowel well permeability and damage from toxic bile acids. Despite of pathogenic hypothesis, a genetic and immunological basis has been implicated in presence of non-activated memory T lymphocytes and variable association with the human leucocyte antigen (HLA) complex.The immune system dysregulation seems to have a key role in both PSC and LP but the connection of the two pathologies is not certain.Otherwise, the association between liver diseases and LP is well documented. Specifically for OLP, an increasing number of reports suggests a chronic liver disease and oral lesion relationship; conversely, the link between cutaneous lichen planus and liver diseases still remain controversial and not all the literature is unanimous. In spite of this, lichen planus is known to be the most frequent skin manifestation of primary biliary cirrhosis where the exposure to penicillamine seems to be a triggering factor for the cutaneous lesion. PSC is also a frequent finding in association with inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, which are also described in relation to OLP. In conclusion, few data concerning the correlation of OLP and PSC are present in literature. This clinical case describes a clinical scenario which is similar to existing reports. More studies should be performed to evaluate the role of the immune system in this pathology and the potential correlation between lichen planus and liver diseases
Enucleation of a multilocular odontogenic keratocyst using sagittal osteotomy: A case report
Full text linkOdontogenic keratocysts are significant cysts of the jaw that are characterized by aggressive behavior and a high tendency to recur. The treatments of choice may be radical or conservative, and in the literature a debate is still open about the gold standard in the treatment of OKCs.This report describes a wide multilocular OKC extended in the right mandibular ramus and illustrates atypical behavior of a cystic lobe after marsupialization, not found to our knowledge in the previous literature. Moreover, an orthognathic procedure, consisting of sagittal osteotomy was chosen for the excision of the cyst to preserve as much bone as possible and the integrity of the inferior alveolar nerve
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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