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Abstract Introduction We present a case of long-term evolution of a submandibular pleomorphic adenoma. There is little information about topographic malignant transformation patterns of pleomorphic adenomas. Case presentation We extensively analyze a giant submandibular mixed tumor of 25-year evolution in a 57-year-old Caucasian woman. Deoxyribonucleic acid ploidy was evaluated in different superficial and deep areas using flow cytometry analysis and correlated with pathological and immunohistochemical characteristics. Superficial areas exhibited a typical histological pleomorphic adenoma pattern and were deoxyribonucleic acid diploid. Deep samples showed deoxyribonucleic acid aneuploidy, atypical histological benign features and expression of markers involved at an early-stage of malignant transformation, such as tumor protein 53 and antigen Ki67. Conclusion These findings revealed that deep tumor compartments may be involved in the initial stages of malignant transformation. Deoxyribonucleic acid ploidy analysis may provide an additional diagnosis tool and indicate 'uncertain' areas that require careful study to avoid diagnostic errors. Larger studies are needed to confirm our results and to evaluate the usefulness of the technique.

Objective: The aim of the present study was to evaluate the effects of ultra-low-frequency transcutaneous electrical nerve stimulation (ULF-TENS) on pain and electromyographic values in subjects affected by temporomandibular disorders. Methods: A retrospective evaluation of 80 non-consecutive patients (58 women, 22 men, mean age 35.3 ± 9.9 years) suffering from pain associated with temporomandibular disorders was performed. The sample was treated with ULF-TENS, and outcomes were evaluated by anamnestic index, dysfunction index, visual analog scale, and surface electromyography of the masticatory muscles. Results: An improvement was seen in pain and electromyographic values. The visual analog scale showed a mean decrease from 8 to 2; surface electromyographic values in the masseter area decreased from 2.7 ± 0.1 to 1.5 ± 0.1. Conclusion: ULF-TENS seems to be effective in reducing pain symptomatology of subjects affected by temporomandibular disorders, with a reduction in the surface electromyographic activity in the masseter area. [ABSTRACT FROM AUTHOR]

Objective To define the association between mandibular fractures and alterations of the cranio-atlo-axial joint (CAAJ). Methods 315 cases of displaced mandibular fractures were retrospectively evaluated by CT scan and cervical X-ray for associated alterations of the CAAJ. Statistical analysis employed the chi-square and Cohen's kappa coefficient. Results Single fractures amounted to 69.84% and multiple fractures to 30.16% of total fractures. CT scans showed a rotation of the atlas on the same side of single fractures and subluxation of the CAAJ. Vertical derangement of the joint was observed in 79.65% of single fractures and in 20.35% of multiple fractures. Approximately16.19% of all displaced mandibular fractures showed cervical disorders at long-term follow-up. Discussion The outcomes of this study revealed an association between traumatic mandibular fractures and CAAJ, accompanied by clinical disorders. These conditions require clinical attention due to their effects on long-term craniocervical functionality and future forensic issues. [ABSTRACT FROM AUTHOR]