Palatal Region Research Articles

Evaluation of the Efficacy of Novel Self Disinfectant Solution in Irreversible Hydrocolloid Impression Material - An Experimental Study.

Irreversible hydrocolloid materials are widely used for both diagnostic and definitive impression procedures. Impressions can be disinfected by immersion or spraying in any compatible disinfectant. Disinfectants should not adversely affect the dimensional stability of the impression and physical properties of impression material and subsequent dental cast. The study aims to evaluate the efficacy of a hypochlorous disinfectant solution mixed with irreversible hydrocolloid on setting time, antibacterial efficacy, and dimensional stability. Three groups were made with one control group and three alginate impression was made for each participants in the maxillary arch with 24-hours intervals between one another using the same brand of commercially available chromatic alginate. The working and setting time were noted. Bacterial swabs were collected using a dry sterile cotton swab in the mid palatal region. Dental casts were made using type III gypsum. The working and setting time had significant differences whereas the dimension among the cast has no significant difference. Microbial growth analysis had distinct differences among the groups. The self disinfection method using a pioneer solution of hypochlorous HOCl (100 ppm) to mix the alginate impression material rather than the water with the same powder-liquid ratio prescribed by the manufacturer had the same dimensional stability with improved antimicrobial action.

Indication and Success Rates of Skeletal Anchorage System in Orthodontics

Skeletal anchorage systems, a pivotal innovation in orthodontics, involve the use of Temporary Anchorage Devices (TADs) or mini-implants, providing stable anchor points in the bone to facilitate precise tooth movements. This comprehensive review article aims to investigate the indications and success rates of skeletal anchorage systems in orthodontics. The research, initiated on November 2nd, 2023, involved an extensive examination of existing literature, utilizing databases like PubMed, Web of Science, and Cochrane. Various components, including mini-screws, mini plates, palatal, buccal shelf implants, and infrazygomatic implants, have enriched orthodontic diversity. Mini screws have displayed remarkable success rates, with most complications related to manageable soft tissue inflammation. Gingival health and smoking habits have been identified as influential factors in mini screw implant success. Mini plates offer sturdy anchorage with resistance to root damage and fracture, surpassing mini screws in overall success rate. Age, implantation site viability, and soft tissue characteristics influence their success. Palatal and buccal shelf implants provide exceptional stability, enhancing the results of fixed bracket appliances. The anterior palatal region is a preferred site for implantation. Infrazygomatic implants, while offering commendable stability, display failure rates within the range of 21-28%, with compromised oral hygiene, immediate loading, inflammation, tooth mobility, and a high mandibular plane angle as potential failure factor. These anchorage methods have expanded treatment possibilities, offering effective solutions for challenging orthodontic cases and ultimately improving patient outcomes.

Polymeric Biomaterials for Topical Drug Delivery in the Oral Cavity: Advances on Devices and Manufacturing Technologies.

There are several routes of drug administration, and each one has advantages and limitations. In the case of the topical application in the oral cavity, comprising the buccal, sublingual, palatal, and gingival regions, the advantage is that it is painless, non-invasive, allows easy application of the formulation, and it is capable of avoiding the need of drug swallowing by the patient, a matter of relevance for children and the elderly. Another advantage is the high permeability of the oral mucosa, which may deliver very high amounts of medication rapidly to the bloodstream without significant damage to the stomach. This route also allows the local treatment of lesions that affect the oral cavity, as an alternative to systemic approaches involving injection-based methods and oral medications that require drug swallowing. Thus, this drug delivery route has been arousing great interest in the pharmaceutical industry. This review aims to condense information on the types of biomaterials and polymers used for this functionality, as well as on production methods and market perspectives of this topical drug delivery route.

Insight into the evolutionary assemblage of cranial kinesis from a Cretaceous bird.

The independent movements and flexibility of various parts of the skull, called cranial kinesis, are an evolutionary innovation that is found in living vertebrates only in some squamates and crown birds and is considered to be a major factor underpinning much of the enormous phenotypic and ecological diversity of living birds, the most diverse group of extant amniotes. Compared to the postcranium, our understanding of the evolutionary assemblage of the characteristic modern bird skull has been hampered by sparse fossil records of early cranial materials, with competing hypotheses regarding the evolutionary development of cranial kinesis among early members of the avialans. Here, a detailed three-dimensional reconstruction of the skull of the Early Cretaceous enantiornithine Yuanchuavis kompsosoura allows for its in-depth description, including elements that are poorly known among early-diverging avialans but are central to deciphering the mosaic assembly of features required for modern avian cranial kinesis. Our reconstruction of the skull shows evolutionary and functional conservation of the temporal and palatal regions by retaining the ancestral theropod dinosaurian configuration within the skull of this otherwise derived and volant bird. Geometric morphometric analysis of the palatine suggests that loss of the jugal process represents the first step in the structural modifications of this element leading to the kinetic crown bird condition. The mixture of plesiomorphic temporal and palatal structures together with a derived avialan rostrum and postcranial skeleton encapsulated in Yuanchuavis manifests the key role of evolutionary mosaicism and experimentation in early bird diversification.

The Effect of Different Intermediary Layer Materials Under Resin Composite Restorations on Volumetric Cuspal Deflection, Gap Formation, and Fracture Strength.

This study investigated the effect of different intermediary layer materials under class II mesio-occluso-distal (MOD) resin composite restorations on volumetric cuspal deflection, gap formation, and fracture strength. In total, 32 sound human maxillary premolars were used. After large, standardized Class II MOD cavities were prepared, a universal adhesive (Clearfil Universal Bond Quick, Kuraray) was applied. The premolars were randomly allocated into four groups according to different intermediary layer materials (n=8): Group Z250 (control)/micro-hybrid composite (Filtek Z250, 3M ESPE); Group EST/low-viscosity bulk-fill resin composite (Estelite Bulk Fill Flow, Tokuyama Dental Corp) + micro-hybrid composite; Group NOV/nanofiber-reinforced low-viscosity composite (NovaPro Flow, Nanova) + micro-hybrid composite; and Group RIB/polyethylene fiber [Ribbond, Ribbond Inc] + micro-hybrid composite. Distilled water was used for storage for 24 hours. Using microcomputed tomography (micro-CT), the teeth were scanned immediately after cavity preparation (T0), then 24 hours after restorative procedures (T1). Volumetric cuspal deflection in cubic millimeters (mm3) was analyzed on the palatal and buccal regions of each restoration individually at T0 and T1 scans. Gap formation (mm3) was evaluated to quantify the volume of black spaces at the tooth-resin interface on the T1 scan. After these scans, using a universal testing machine, the teeth were subjected to a fracture strength test (0.5 millimeters/minute [mm/min]). The fracture surfaces were analyzed with a stereomicroscope. The data were analyzed using the Kruskal-Wallis, one-way analysis of variance (ANOVA), and Dunn's tests (p< 0.05). No significant differences in volumetric cuspal deflection and fracture strength were detected for all tested groups (p>0.05). Group RIB exhibited significantly higher gap formation values in comparison with all other groups (p<0.05). Predominant failure mode was favorable.

Orthopedic and surgical rehabilitation children with unilateral cleft/palat

Introduction. Maxillofacial fissures are the most common form of congenital malformations of the face and the maxillofacial region. These forms of malformations may vary from simple shapes to particularly non-specific forms. The cleft lip and palate are characterized by anatomical and functional disorders. In unilateral total splits, anatomical disorders are characterized by bone deformities. The upper jaw is divided into two segments by the fissure that passes on the upper lip, alveolar and hard palatal process and soft palatal region. The clinical manifestations of these forms of malformations appear with severe aesthetic facial deformities and functional disorders that can lead to a chain of clinical diseases that endagers even the vital functions of the child.Background. During the years of research in order to find a better optimal way to treat the cleft palate, there was described a lot of controversary methods and steps to reduce the dimension of the cleft, using prenasoalveolar molding appliances and different types of surgical methods(one or 2 steps plasty of the palate).Materials and methods. Six patients with total palatal splitting were examined. There were done impression and obtained study gypsum models during preoperative to the primary stage of plasty and postoperatively to the secondary stage of plasty of the hard palate.Results. According to the measurements and calculations, we came to the conclusion that the two-stage plasty, only with passive therapy of separation of the nasal cavity from the oral cavity with the help of palatal plates, has a displace-ment efficiency of the splitting segments of 46%, while one-stage palatal plasty with active preoperative nasal-alveolar molding with intermaxillary traction has a closure value of 76% (after Elcin).Conclusion. One-stage cleft palate surgery, which preoperatively undergoes orthodontic nasal-alveolar molding ther-apy, is more effective in closing the cleft at the level of the alveolar processes than two-stage plastic surgery without preoperative nasal-alveolar orthodontic therapy.

Adjuvant therapy with imatinib for an incompletely resected multilobular tumour of bone in a dog

A 5-year-old neutered male Shiba Inu dog presented with a history of oral bleeding, dysphagia, and depression for 3 weeks. The physical examination revealed a firm mass in the right caudal palatal region along the level of PM4–M2. On the computed tomography, the mass was round-to-oval in shape and 22 mm × 30 mm × 15 mm in size. The mass contained multiple bone attenuated materials with a palatal bone lysis of 4 mm × 6 mm. A complete resection of the mass was proposed; however, the owner declined due to the risk of complications associated with the radical surgery. Therefore, a palliative resection and biopsy of the mass were performed. On the histological examination, the mass was diagnosed as grade 2 multilobular tumour of bone (MTB). Since the mass was incompletely resected, adjuvant therapy was pursued along with targeted therapy using a tyrosine kinase inhibitor. The tumour cells showed overexpression of the receptor of tyrosine kinase for c-KIT, PDGFR-α, PDGFR-β, and FGFR1 compared to normal tissue cells. Additionally, the cytotoxic effect of imatinib on the MTB cells was confirmed in vitro. Four weeks postoperatively, the administration of imatinib and carprofen was initiated and continued for 259 days. The patient maintained a good functional outcome for 306 days after the initial presentation.

Feasibility of using dental putty-based custom molds for high-dose-rate brachytherapy of oral mucosal melanoma

PurposeTo investigate the feasibility of using dental putty to fabricate custom molds for high-dose-rate (HDR) brachytherapy of oral mucosal melanoma. Practical guidelines of using dental putty for the custom mold fabrication are presented. MethodsDose measurements were performed using radiochromic films to understand the dosimetric characteristics of dental putty. The percentage depth dose (PDD) and profile curves were obtained using a single Co-60 source located on top of a cubic volume of the dental putty. Two custom molds were fabricated for a patient with mucosal melanoma lesions, which were spread throughout the right mandibular gingiva and soft palate regions. Furthermore, pretreatment dosimetry for both lesions was performed to evaluate the delivery quality of the resulting HDR brachytherapy plans and adjust the overall dose level. ResultsPrescribed doses for the two oral cavity regions were successfully delivered with a reasonable dose uniformity. Based on the measured single-source PDD curve, the maximum dose was observed at a depth of approximately 1 mm, which indicated steep dose gradients at depths ranging from 0 to 2 mm. Furthermore, a simulation with the measured single-source two-dimensional profile revealed that a source-to-source distance of 10 mm was appropriate to generate a uniform dose distribution at a source-to-surface distance of 5 mm. ConclusionsThe use of a custom mold was found to be feasible for HDR brachytherapy while carefully considering the source-to-surface and source-to-source distances. Pretreatment delivery verification would be necessary when a uniform dose distribution is required.

Midpalatal suture bone repair after miniscrew-assisted rapid palatal expansion in adults

BackgroundMidpalatal suture (MPS) repair in growing patients after RPE has been previously reported. However, differences between young and adult patients for timing and pattern of MPS repair after rapid maxillary expansion are expected. The aim of this study was to evaluate the midpalatal suture repair pattern after miniscrew-assisted rapid palatal expansion (MARPE) in adult patients.Materials and methodsThe study included 21 patients (six males, 15 females) successfully treated with MARPE with a mean initial age of 29.1 years of age (SD = 8.0; range = 20.1–45.1). MPS repair was evaluated using maxillary axial and coronal sections derived from CBCT exams taken 16 months after the expansion (SD = 5.9). Objective and subjective assessments of MPS repair were performed. Objective assessments were performed measuring MPS bone density at anterior, median and posterior region of hard palate. Pre-expansion and post-retention bone density changes were evaluated using paired t tests (p < 0.05). Midpalatal suture bone repair was scored 0 to 3 considering, respectively, the complete absence of bone repair in the MPS, the repair of less than 50% of the MPS, the repair of more than 50% of the MPS and the complete repair of the MPS. Intra- and interexaminer reliability evaluation were assessed using Kappa coefficient.ResultsThe objective evaluation showed a significant higher bone density at the pre-expansion stage in all palatal regions. The reliability of the subjective method was adequate with intra- and interexaminer agreements varying from 0.807 to 0.904. Scores 1, 2 and 3 were found in 19.05%, 38.09% and 42.86% of the sample, respectively. The most common region demonstrating absence of bone repair was the middle third. The anterior third of the midpalatal suture was repaired in all patients.ConclusionsA decreased bone density was observed after the retention period when compared to pre-expansion stage. Most adult patients demonstrated incomplete repair of the midpalatal suture 16 months after MARPE. However, adequate bone repair covering more than half of the hard palate extension was observed in 80.95% of the patients.

An Unusual Presentation of Spindle Cell Tumor on Palate

Spindle cell tumors are rarely reported in the oral cavity. Since the subtypes of these lesions are very difficult to diagnose, immunohistochemistry is a useful diagnostic tool. Here, we report a case of benign spindle cell tumor on palate. A 49 year old male presented with irregular mass of approximately 2 × 2 cm on maxillary right posterior region of palate since 2 months. Excisional biopsy and immunohistochemistrydetermine it as benign spindle cell tumor.

Fossil basicranium clarifies the origin of the avian central nervous system and inner ear.

Among terrestrial vertebrates, only crown birds (Neornithes) rival mammals in terms of relative brain size and behavioural complexity. Relatedly, the anatomy of the avian central nervous system and associated sensory structures, such as the vestibular system of the inner ear, are highly modified with respect to those of other extant reptile lineages. However, a dearth of three-dimensional Mesozoic fossils has limited our knowledge of the origins of the distinctive endocranial structures of crown birds. Traits such as an expanded, flexed brain, a ventral connection between the brain and spinal column, and a modified vestibular system have been regarded as exclusive to Neornithes. Here, we demonstrate all of these ‘advanced’ traits in an undistorted braincase from an Upper Cretaceous enantiornithine bonebed in southeastern Brazil. Our discovery suggests that these crown bird-like endocranial traits may have originated prior to the split between Enantiornithes and the more crownward portion of avian phylogeny over 140 Ma, while coexisting with a remarkably plesiomorphic cranial base and posterior palate region. Altogether, our results support the interpretation that the distinctive endocranial morphologies of crown birds and their Mesozoic relatives are affected by complex trade-offs between spatial constraints during development.

Influence of nasal septum deviation on fluctuating asymmetries of the nasomaxillary complex: A cross‐sectional study

An important parameter in diagnostic analysis and treatment planning of different biological areas is facial symmetry, and several etiological factors have been attributed to skeletal facial asymmetry. Although causality cannot be determined, previous studies have reported a relationship between the anatomical deviation of the nasal septum and facial development. Diagnosis is critical for patients in growth stages due to the association between nasal septum deviation (NSD) and abnormal growth of the nasomaxillary complex. To understand this relationship, this study aimed to investigate the influence of nasal septum deviation on fluctuating asymmetries (FA) of the nasomaxillary complex at different stages of skeletal maturation. Another goal was to determine whether an association exists between the degrees of septal deviation severity and asymmetry of the nasomaxillary complex. This was a retrospective, cross-sectional observational study comprising 60 selected cone-beam computed tomography (CBCT) scans that were divided into four groups (n= 15) according to the degree of septal deviation and skeletal maturation: mild deviation (MD; <10°), moderate to severe deviation (MSD; ≥10°), early group (EG), and late group (LG). The angle and area of deviation were measured for the greatest NSD, and a geometric morphometric approach was used to evaluate the nasal septum (NS) shape. The morphology of the nasomaxillary complex and the presence of fluctuating asymmetries were evaluated using 23 two-dimensional landmarks on the nasomaxillary complex (nasal, lateral, and palatal regions) with Procrustes ANOVA and Mann-Whitney test. Additionally, Spearman's correlation and multivariate regression were used to correlate the NSD with asymmetries in these regions. No significant differences were observed in the Procrustes FA scores of the nasomaxillary complex between the MD-EG × MSD-EG and MD-LG × MSD-LG (p> 0.05). However, the results of the multivariate regression revealed more specific aspects of asymmetry (asymmetry component), there was a positive correlation between the NSD angle and the palatal regions (p= 0.035 and p= 0.047, middle and posterior, respectively), and the nasal septum shape and anterior palatal regions (p= 0.039). The nasal and lateral regions did not correlate with the NSD angle in the multivariate regression analysis (p> 0.05). The results of this study indicate that there were no significant differences in the fluctuating asymmetry of the nasomaxillary complex between the mild and moderate to severe nasal septum deviation groups, in both early and late skeletal maturation stages. However, a positive correlation was observed in the degree of nasal septum deviation angle and asymmetry components of the middle and posterior palatal regions, likewise between the nasal septum shape and asymmetry components of the anterior palatal region. The diagnosis of nasal septum deviation by both physicians and dentists is important, as a relationship was observed with fluctuating asymmetry component of the palatal region. This information can guide the decision of the treatment planning for these individuals, and should be considered, especially in cases of severe septum deviation, due to the great anatomical proximity of these structures.

Mini-Implant Rejection Rate in Teenage Patients Depending on Insertion Site: A Retrospective Study.

Mini-implants have undeniable advantages in Orthodontics. However, the use of mini-implants shows some limitations and disadvantages related to patient age, the quality of the bone tissue, the characteristics of the oral mucosa, implant site, the state of health of the organism and the quality of oral hygiene. The aim of this paper was to analyze the rejection rate of mini-implants in teenage patients, depending on their insertion site, and examine their stability up to three months after insertion. This retrospective study was conducted on dental charts belonging to patients aged between 12 and 17 years, from Oradea, Romania. The mini-implants were placed for various therapeutic reasons and were inserted in the following sites: buccal maxillary area, the infrazygomatic region, palatal area, buccal mandibular area and lingual area; they had a diameter of 1.6 mm (inter-radicular spaces) and of 2 mm (nonbearing tooth areas), and a length of 6–8 mm (mandible) or 8–10 mm (maxilla). The rejection rate was checked in the first month, second month, third month and after the third month from insertion. A total of 432 patients were included in the study, and they had a total of 573 mini-implants. Most implants were placed in the buccal region of the maxilla (27.7%), and most patients had one mini-implant placed (65.7%). The highest rejection rate was obtained in the first month (15.2%). The rejection rate between genders was similar. The mini-implants from the buccal mandibular region had a significantly higher rate of rejection in the first month (M1) in comparison to the mini-implants from the palatal region (24.4% vs. 8.3%). The mini-implants from the lingual region of the mandible had a significantly higher rate of rejection in the second month (M2) in comparison to the mini-implants from the infrazygomatic or the palatal region (10.5% vs. 0%/0%). Mini-implants are very useful for carrying out various orthodontic treatments, but their stability should be enhanced.

Sinonasal Mucormycosis with an Unusual Involvement of Palate

Mucormycosis is caused by a fungal infection that belongs to the order of Mucorales and is one of the rapidly spreading infections of the human body. Rhizopus species are the most common etiological agent associated with mucormycosis. It is an emergency clinical condition and has a poor prognosis. The most common variant of the mucormycosis is rhinocerebral type which may spread to the orbit and brain. The identification of mucormycosis in the palatal region is often rare and late occurrence. A case of multiple ulcerations in the palatal region occurs due to sinonasal mucormycosis in a 55-year-old is reported. He was known case of diabetes mellitus and was diagnosed with coronavirus disease 2019 infection 1 year back but recovered with conservative treatment at home. Anterior rhinoscopy showed purulent discharge in both nostrils. He had no swelling in the face and neck. No tenderness was found in the head-and-neck region. He was successfully managed by surgical debridement combined with systemic liposomal amphotericin B for 6 weeks. The survival of patients is often dependent on early diagnosis and treatment.

Accuracy of palatal orthodontic mini-implants placed by conventionally or CAD/CAM-based surgical guides: a comparative in vitro study.

To investigate and compare the transfer accuracy of five different surgical guides (SGs) for the insertion of orthodontic mini-implants (OMIs) in the anterior palate. Stereolithographic files of 10 maxillary patient models and their corresponding lateral cephalograms were virtually matched and used for planning the position of two parallel OMIs in the paramedian region of the anterior palate. For each patient model, three 3-dimensional (3D)-printed and two conventional SGs were manufactured from different materials, and a total of 96 OMIs were transferred to the anterior palates of the respective 50 molded resin models. The planned (T0) and the actual (T1) OMI positions were analyzed and compared after superimposition of the digitized models. The deviations between the OMI positions in T0 and T1 were described as the distance between the head and the tip, respectively, of each OMI in millimeters and the deviating angle between the OMI axes for each patient and SG. The conventionally manufactured SGs of Pattern Resin LS (GC Europe N.V., Leuven, Belgium) showed the highest linear and angular transfer accuracy for the insertion of OMIs. The highest deviations were found with the SGs made of IMPRIMO LC Splint (3D-printed; Scheu-Dental, Iserlohn, Germany) and Memosil 2 (conventional SG; Kulzer, Hanau, Germany). The 3D-printed SGs did not reach the accuracy of the conventional SGs made of Pattern Resin but may provide sufficient accuracy for palatal OMI placement.

A Giant Pyogenic Granuloma on the Hard Palate

Pyogenic granuloma (PG) is a hyperplastic and inflammatory lesion found in the oral cavity. Exuberant tissue response to trauma or local irritation is believed to cause PG. In the second decades of their life, it is commonly seen in young women, owing to vascular hyperplasia caused by female hormones. The clinical presentations are smooth or lobulated exophytic mass and sessile or pedunculated red to pink. The size of the PG may vary from a few millimeters to several centimeters. Gingiva is the common site for PG in the oral cavity. PG very rarely involves the hard palate. However, there is a high chance of PG in the oral cavity during pregnancy. Therefore, complete surgical excision of the lesion is the treatment of choice. Here, this case report presents PG in the hard palate region of an 18-year-old female, a scarce location for this lesion.

Comparación de la adaptación marginal y microfiltración entre dos sistemas de zirconia, con un mismo medio cementante

Objetivo: Comparar la adaptación marginal y microfiltración de las cofías Lava™ y Zirkon zahn® con un mismo medio cementante. Materiales y Métodos: Veinte premolares superiores extraídos fueron divididos en dos grupos. Un grupo fue preparado para recibir cofías de Lava™ y el otro para Zirkon zahn®. Las cofías fueron elaboradas siguiendo los estándares de cada sistema. Fue medida la adaptación marginal en micras en ocho zonas antes y después de ser cementadas con RelyX™ U100. Después de termocicladas las muestras fueron embebidas en fushina al 2% y seccionadas bucopalatino, para medir la microfiltración en micras en cada sección tanto en vestibular como en palatino. Resultados: Existió una diferencia estadística significativa en la adaptación marginal entre los dos sistemas de zirconia. El sistema que reportó mejor adaptación fue Lava™ con valores de 19.7µm antes de cementar y 15.0µm después de cementar, el sistema con menor adaptación marginal fue Zirkon zahn® con valores de 28.1µm antes de cementar y 22.8µm después de cementar. No hubo una diferencia significativa en la microfiltración, el promedio para Lava™ fue de 314.2µm y de Zirkon zahn® de 319.8µm. Conclusión: El sistema que reportó mejor ajuste marginal, con una diferencia estadística significativa, fue Lava™, por lo que el sistema con menor ajuste marginal fue Zirkon zahn®, sin embargo no hubo diferencia significativa en la microfiltración entre estos sistemas.

Miniscrews for orthodontic anchorage: analysis of risk factors correlated with the progressive susceptibility to failure

The phenomenon of orthodontic anchorage miniscrews loosening after being implanted several times happens in daily clinical practice, and the reasons need to be traced. This study aimed to investigate the underlying risk factors influencing the progressive susceptibility of orthodontic miniscrews to failure. Overall, 889 miniscrews were successively inserted into 347 patients because some loosened or fell off once, twice, or more before achieving their purposes. The number of miniscrew failures (ie, once, twice, or more) was defined as progressive susceptibility to failure. The clinical indicators were assessed via univariate analysis, multicollinearity diagnosis, and Poisson log-linear regression model with stepwise calculation to screen out. The progressive susceptibility of miniscrews to failure was proved to be affected by the age of patients, the onset of force application, site of placement, and appliance type. Age and onset of force application presented a negative relationship with susceptibility. Miniscrews inserted in the palatal region appeared to be more stable than the forepart of the arch. In contrast, the retromaxillary and retromandibular areas obtained the lowest stability. The patients with fixed appliances were more unlikely to suffer progressive failure than removable appliances. In addition, the larger number of screws inserted in each patient, the greater probability of failure. Younger people with removable appliances that miniscrews inserted in the retromaxillary or retromandibular regions and earlier onsets of loading had a higher progressive susceptibility to loosening. Meanwhile, the failure rate was elevated with the increasing number of screws per patient received.

PLEOMORPHIC ADENOMA IN PALATE

Pleomorphic adenoma is a common benign neoplasm of the major and minor salivary glands. It is identified through clinical characteristics. A 13-year-old female patient sought dental care for an expressive and round swelling with a smooth surface in the palate region. A panoramic radiograph was requested and on clinical examination a solid lesion with well-defined borders and no association with pain symptoms was observed. Therefore, an aspiration puncture was executed before the surgical procedure, in which total enucleation of the lesion was performed. The specimen was sent for histopathologic examination, establishing the definitive diagnosis of pleomorphic adenoma. Observing the slide, the presence of neoplastic cells around the lesion was noticed, suggesting the potential risk of malignancy. The patient has been in follow-up for 5 months and there are no signs of relapse. Pleomorphic adenoma is a common benign neoplasm of the major and minor salivary glands. It is identified through clinical characteristics. A 13-year-old female patient sought dental care for an expressive and round swelling with a smooth surface in the palate region. A panoramic radiograph was requested and on clinical examination a solid lesion with well-defined borders and no association with pain symptoms was observed. Therefore, an aspiration puncture was executed before the surgical procedure, in which total enucleation of the lesion was performed. The specimen was sent for histopathologic examination, establishing the definitive diagnosis of pleomorphic adenoma. Observing the slide, the presence of neoplastic cells around the lesion was noticed, suggesting the potential risk of malignancy. The patient has been in follow-up for 5 months and there are no signs of relapse.

EARLY DIAGNOSIS AND TREATMENT IN TWO CASES OF MICROINVASIVE SQUAMOUS CELL CARCINOMA ON THE PALATE

Squamous cell carcinoma (SCC) is the most common malignancy that affects the oral cavity. It is related to smoking and drinking, which can increase the carcinogenic effect. The objective of the work is to report 2 cases of microinvasive SCC, presenting their clinical characteristics and emphasizing early diagnosis and clinical management. Case 1: A 65-year-old male smoker undergoing treatment for prostate adenocarcinoma with bone metastasis and use of alendronate complained of bilateral white plaques on the palate without painful symptoms. Case 2: A 43-year-old female smoker with no comorbidities presented with a shallow ulcer in the palate region. The diagnostic hypotheses were mild dysplasia and SCC. Incisional biopsies were performed and histopathologic reports revealed microinvasive SCC. The patients were referred for treatment. It was concluded that the dentist must be attentive to the diagnosis of oral lesions for a favorable prognosis and patient survival. Squamous cell carcinoma (SCC) is the most common malignancy that affects the oral cavity. It is related to smoking and drinking, which can increase the carcinogenic effect. The objective of the work is to report 2 cases of microinvasive SCC, presenting their clinical characteristics and emphasizing early diagnosis and clinical management. Case 1: A 65-year-old male smoker undergoing treatment for prostate adenocarcinoma with bone metastasis and use of alendronate complained of bilateral white plaques on the palate without painful symptoms. Case 2: A 43-year-old female smoker with no comorbidities presented with a shallow ulcer in the palate region. The diagnostic hypotheses were mild dysplasia and SCC. Incisional biopsies were performed and histopathologic reports revealed microinvasive SCC. The patients were referred for treatment. It was concluded that the dentist must be attentive to the diagnosis of oral lesions for a favorable prognosis and patient survival.