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Gracias al auge de las nuevas tecnologías de la información y la expansión de las mismas, la docencia de los alumnos ha experimentado un gran avance poniendo a disposición del alumnado videos, trabajos y material complementario a su alcance en cualquier lugar y momento. La accesibilidad inmediata a contenidos multimedia, ayuda al estudiante a una mejor planificación diaria de su trabajo facilitando la adquisición de nuevos conocimientos de una forma más interactiva y visual, resultando en un aprendizaje más dinámico que puede llegar a complementar los tradicionales libros de texto. La patología de la articulación temporomandibular es altamente prevalente y en hospitales no terciarios el Cirujano maxilofacial no está presente, pudiendo colaborar en su tratamiento los odontólogos, los cirujanos generales, los cirujanos plásticos y reparadores e incluso servicios de dermatología. Existen distintas técnicas diferentes a la hora de abordar las diferentes patologías, que abarcan desde el uso de férulas de descarga, así como tratamientos mínimamente invasivos como pueden ser la artrocentesis, la artroscopia y la infiltración de neuromoduladores a nivel muscular. La grabación de estas técnicas permite al estudiante disponer de una herramienta eficaz a la hora de su aprendizaje, y además si colaboran en la grabación y el montaje de dichos videos se potencia dicho aprendizaje. No todos los estudiantes de medicina tienen la posibilidad de acceder a rotaciones en todos los servicios, y sólo una minoría de estudiantes de posgrado de odontología acceden a rotaciones en el Servicio de Cirugía Oral y Maxilofacial. Por tanto, la finalidad de estas grabaciones, es acercar al estudiante estas técnicas terapéuticas de una forma atractiva y dinámica permitiendo un aprendizaje activo en el que estudiante pueda llegar a sentirse involucrado.

Introduction: The COVID-19 pandemic has induced profound societal and healthcare transformations globally. Material and methods: This multicenter retrospective study aimed to assess potential shifts in the epidemiology and management of oromaxillofacial trauma requiring surgical intervention over a 1-year period encompassing the onset of the COVID-19 pandemic, in comparison to the preceding year. The parameters investigated included age, sex, injury mechanisms, fractured bones, and treatment modalities. The statistical significance was set at p < 0.05. Results: A notable 39.36% reduction in oromaxillofacial fractures was identified (p < 0.001), with no significant alterations in sex distribution, types of fractured bones, or treatment modalities. An appreciable increase in mean age was observed (35.92 vs. 40.26) (p = 0.006). Analysis of the causes of oromaxillofacial trauma revealed diminished incidents of interpersonal violence (41% vs. 35%) and sports-related injuries (14% vs. 8%), alongside an escalation in cases attributed to falls (27% vs. 35%), precipitation events (2% vs. 5%), and traffic accidents (12% vs. 13%). The mandible emerged as the most frequently fractured bone. Conclusion: In conclusion, the COVID-19 pandemic has decreased the number of maxillofacial fractures treated surgically and has changed the epidemiology and the etiology of facial traumas., Depto. de Cirugía, Fac. de Medicina, TRUE, pub, Descuento UCM

Background: Genioplasty as an isolated surgical technique is a highly demanded procedure in the maxillofacial surgery area. Advances in facial reconstructive surgery have been associated with less morbidity and more predictable results. In this paper, “conventional” genioplasty and genioplasty by means of virtual surgical planning (VSP), CAD-CAM cutting guides, and patient custom-made plates are compared. Methods: A descriptive observational study was designed and implemented, and 43 patients were treated, differentiating two groups according to the technique: 18 patients were treated by conventional surgery, and 25 patients were treated through virtual surgical planning (VSP), CAD-CAM cutting guides, STL models, and titanium patient-specific plates. Results: The operation time ranged from 35 to 107 min. The mean operative time in the conventional group was 60.06 + 3.74 min.; in the custom treatment group it was 42.24 + 1.29 min (p < 0.001). The difference between planned and obtained chin changes in cases of advancement or retrusion was not statistically significant (p = 0.125; p = 0.216). In cases of chin rotation due to asymmetry, guided and personalized surgery was superior to conventional surgery (p < 0.01). The mean hospital stay was equal in both groups. A decrease in surgical complications was observed in the group undergoing VSP and customized treatment. Conclusions: Multi-stage implementation of VSP with CAD-CAM cutting guides, STL models, and patient-specific plates increased the accuracy of the genioplasty surgery, particularly in cases of chin asymmetry, reducing operation time and potential complications., Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub, Descuento UCM

Background: The American Joint Committee on Cancer (AJCC), in its 8th edition, introduces modifications to the previous TNM classification, incorporating tumour depth of invasion (DOI). The aim of this research is to analyse the prognosis (in terms of disease-free survival and overall survival) of clinical early stage (I and II) squamous cell carcinomas of the oral tongue according to the DOI levels established by the AJCC in its latest TNM classification to assess changes to the T category and global staging system and to evaluate the association between DOI and other histological risk factors. Methods: A retrospective longitudinal observational study of a series of cases was designed. All patients were treated with upfront surgery at our institution between 2010 and 2019. The variables of interest were defined and classified into four groups: demographic, clinical, histological and evolutive control. Univariate and multivariate analyses were carried out and survival functions were calculated using the Kaplan–Meier method. Statistical significance was established for p values below 0.05. Results: Sixty-one patients were included. The average follow-up time was 47.42 months. Fifteen patients presented a loco-regional relapse (24.59%) and five developed distant disease (8.19%). Twelve patients died (19.67%). Statistically significant differences were observed, with respect to disease-free survival (p = 0.043), but not with respect to overall survival (p = 0.139). A total of 49.1% of the sample upstaged their T category and 29.5% underwent modifications of their global stage. The analysis of the relationship between DOI with other histological variables showed a significant association with the presence of pathological cervical nodes (p = 0.012), perineural invasion (p = 0.004) and tumour differentiation grade (p = 0.034). Multivariate analysis showed association between depth of invasion and perineural invasion. Conclusions: Depth of invasion is a histological risk f, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub, Descuento UCM

Background This study aimed to evaluate the diagnostic performance of serum inflammatory biomarkers in salivary gland tumors with dubious results following cytological analysis. Methods A retrospective analysis of 239 cases following surgery between January 2011 and June 2022 was performed. Receiver Operating Characteristic curves were drawn and areas under the curves were computed to evaluate the diagnostic performance of the inflammatory biomarkers (SII, SIRI, PLR, and NLR). Optimal cut-offs for each marker were determined by maximizing the Youden index. Results Analysis showed that among the major biomarkers examined, SIRI performed an AUC of 0.77. The best SIRI cut-off was 0.94 with an accuracy of 79.9%. The accuracy, sensitivity, and specificity of cytological analysis were 77.8%, 59.6%, and 90.7% respectively. By combining SIRI with cytological analysis we demonstrated an increase in sensitivity to 82.8%. Conclusions Inflammatory biomarkers could be evaluated to support the diagnosis and treatment of salivary gland tumors in difficult cases., Depto. de Cirugía, Fac. de Medicina, TRUE, pub, APC financiada por la UCM

Lymph node density (LND)—the proportion of positive nodes among the total number of resected nodes—has emerged as a reliable prognostic factor in solid tumors. This study aims to assess the importance of LND in lingual squamous cell carcinoma (LSCC) and its prognostic involvement. A retrospective longitudinal study with 62 patients was performed. All patients were diagnosed with LSCC and submitted for tumor resection and neck dissection. Patients were stratified into low (<0.04) and high risk (≥0.04) based on LND. We analyzed the impact of LND on overall survival (OS) and disease-free survival (DFS), as well as the relationship between LND and the pathological staging, the involvement of positive margins, depth of invasion (DOI) and perineural infiltration. This study provides a substantial relationship between lymph node density (LND), overall survival (OS) and disease-free survival (DFS) in lingual squamous cell carcinoma (LSCC). A statistically significant distribution was found between LND, perineural infiltration and pathological staging, whereas no association was found with the rest of the prognostic variables analyzed., Depto. de Cirugía, Fac. de Medicina, TRUE, pub, Descuento UCM

Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the first two decades of life. One third of cases appear in the head and neck, with 60% of these being embryonal type. RMS is extremely rare in adults, comprising only 1% of adult malignancies, and of those, only 3.3% are rhabdomyosarcomas. (2) Case report: A 46 y.o. male presented with a 1 cm exophytic pediculated painless lesion on the dorsum of his tongue, with progressive growth for 3 months. An excisional biopsy revealed an “embryonal rhabdomyosarcoma with fusocellular areas, with negative rearrangement for gen FOXO1A, negative MDM2 (only focal positivity), and positive INI-1”. Subsequent contrast-enhanced MRI concluded the presence of a lesion with imprecise margins in the right half-tongue, 15 × 8 × 7 mm (longitudinal × transverse × craniocaudal), compatible with a sarcoma. The patient underwent a partial centrolingual glossectomy followed by reconstruction with a buccinator muscle local flap. After surgery, he received chemotherapy with eight cycles of VAC (vincristine, actinomycin, and cyclophosphamide) protocol. The patient is now disease free after 42 months, with good tongue function. (3) Discussion and conclusions: Embryonal RMS is an extremely rare sarcoma in adults, and the location in the tongue is even more exceptional (only two more similar cases are reported in the literature). The prognosis in adults is significantly poorer than in children. A complete margin-free resection with an adequate chemotherapy protocol is the treatment of choice in cases such as these., Instituto de Salud Carlos III, Unión Europea, Depto. de Cirugía, Fac. de Medicina, TRUE, pub, APC financiada por la UCM

(1) Background: This study aimed to analyze if the serum albumin levels of hospitalized SARS-CoV-2 (COVID-19) patients on admission could predict <30 days in-hospital all-cause mortality, and if glucose levels on admission affected this predictive ability. (2) Methods: A multicenter retrospective cohort of 1555 COVID-19-infected adult patients from public hospitals of the Madrid community were analyzed. (3) Results: Logistic regression analysis showed increased mortality for ages higher than 49 y. After adjusting for age, comorbidities and on-admission glucose levels, it was found that on-admission serum albumin ≥3.5 g/dL was significantly associated with reduced mortality (OR 0.48; 95%CI:0.36–0.62). There was an inverse concentration-dependent association between on-admission albumin levels and <30 days in-hospital all-cause mortality. However, when on-admission glucose levels were above 125 mg/dL, higher levels of serum albumin were needed to reach an association with survival. In vitro experiments showed that the spike protein S1 subunit of SARS-CoV-2 binds to native albumin. The binding ability of native albumin to the spike protein S1 subunit was decreased in the presence of an increasing concentration of glycated albumin. (4) Conclusions: On-admission serum albumin levels were inversely associated with <30 days in-hospital all-cause mortality. Native albumin binds the spike protein S1 subunit, suggesting that native albumin may act as a scavenger of the SARS-CoV-2 virus., Depto. de Cirugía, Depto. de Medicina, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

The aim of this study is to evaluate the functional outcomes and quality of life (QoL) in oncologic patients with intraoral defects reconstructed with the buccinator myomucosal flap. A retrospective study was performed involving 39 patients with intraoral soft-tissue defects, reconstructed with a buccinator myomucosal flap during a six-year period. Patients completed the European Organization for Research and Treatment of Cancer questionnaires, the standard questionnaire (QLQ-C30) and the head-and-neck specific module (QLQ-H&N35). Thirty-nine patients with a mean age of 61.23 ± 15.80 years were included in the study. Thirty-three patients were diagnosed with an oncological condition (84.61%). Six patients (15.38%) developed orosinusal communication and underwent extensive debridement. The median global-health-status score was 79.27 and emotional performance was the lowest scoring, with a mean score of 76.93. As for the symptom items, the most outstanding were dental problems (33.33), oral opening (31.62) and dry mouth (37.61), followed by sticky saliva (24.79), problems with social eating (21.15) and pain (19.87). The most significant symptoms were radiotherapy-related adverse effects such as pain, fatigue, dental problems and dry mouth. Patients reconstructed with the buccinator myomucosal flap develop a good quality of life for all types of activities, and a correct function and aesthetics. Postoperative radiotherapy is associated with a poorer quality of life, and can lead to impairment of several symptoms such as swallowing, oral opening and dry mouth., Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Background and Objectives: Aspirin (ASA) is a commonly used antithrombotic drug that has been demonstrated to reduce venous thromboembolism. The aim was to analyze if geriatric COVID-19 patients undergoing a 100 mg/day Aspirin (ASA) treatment prior to hospitalization differ in hospital outcome compared to patients without previous ASA therapy. Materials and Methods: An observational retrospective study was carried out using an anonymized database including geriatric COVID-19 patients (March to April 2020) admitted to Madrid Hospitals Group. A group of COVID-19 patients were treated with low ASA (100 mg/day) prior to COVID-19 infection. Results: Geriatric ASA-treated patients were older (mean age over 70 years; n = 41), had higher frequency of hypertension and hyperlipidemia, and upon admission had higher D-dimer levels than non-ASA-treated patients (mean age over 73 years; n = 160). However, patients under ASA treatment did not show more frequent pulmonary thromboembolism (PE) than non-ASA-treated patients. ASA-treated geriatric COVID-19-infected patients in-hospital < 30 days all-cause mortality was more frequent than in non-ASA-treated COVID-19 patients. In ASA-treated COVID-19-infected geriatric patients, anticoagulant therapy with low molecular weight heparin (LMWH) significantly reduced need of ICU care, but tended to increase in-hospital < 30 days all-cause mortality. Conclusions: Prior treatment with a low dose of ASA in COVID-19-infected geriatric patients increased frequency of in-hospital < 30 days all-cause mortality, although it seemed to not increase PE frequency despite D-dimer levels upon admission being higher than in non-ASA users. In ASA-treated geriatric COVID-19-infected patients, addition of LMWH therapy reduced frequency of ICU care, but tended to increase in-hospital < 30 days all-cause mortality., Depto. de Medicina, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

(1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperative virtual planning of mandibular reconstruction using a free fibula flap compared with freehand plate bending and osteotomies. (2) Methods: A retrospective comparative study was carried out in the Oral and Maxillofacial Department of La Paz University Hospital, Madrid, Spain. The study compared 18 patients in the CAD/CAM group with 19 patients in the conventional freehand group. A comparison was made between the total surgical time, the comorbidities, and the hospital stay. The resource consumption was estimated using a cost analysis. (3) Results: Although CAD/CAM was a statistically more expensive procedure in the perioperative phase, no significant differences were observed in total health care costs between the two groups. There was a non-significant trend towards an increase in complications with conventional reconstruction plates compared to patient-specific plates (PSI). (4) Conclusions: CAD/CAM technology and a 3D printed cutting guide offer a significantly shorter surgical time, which is associated with a reduction in hospital days, PACU days, and complications. The cost of CAD/CAM technology is comparable to that of the conventional freehand technique., Fac. de Medicina, TRUE, pub

Background Descending necrotising mediastinitis is one of the most lethal and least frequent forms of mediastinitis. It is a life-threatening infection most frequently originating from an oropharyngeal or odontogenic infection. Material and Methods A retrospective study of 6 patients diagnosed and treated for descending necrotising mediastinitis between 2015 and 2020 is reported. Results All patients were male, mean age of 34.83 years; 66% were smokers. 83% had an orocervical infection and 34% had initial mediastinal spread. All patients were treated initially with empirical broad-spectrum antibiotics and surgical drainage, with subsequent admission to the Intensive Care Unit; only one of them required tracheostomy. The mean hospital stay was 27.37 days. After a mean follow-up of 6 months, 100% of the cases had a complete recovery. Conclusions Early diagnosis and surgical treatment combined with improved life-support treatment in intensive care units and broad-spectrum antibiotic therapy leads to a decrease in associated mortality., Depto. de Cirugía, Fac. de Medicina, TRUE, pub

La salivación es un proceso fisiológico dependiente de las glándulas salivales. En reposo, el 70% de la saliva es secretada por las glándulas submaxilares. Sin embargo, bajo estimulación, el flujo salival aumenta, hasta cinco veces, siendo la glándula parótida la principal responsable. La sialorrea se define como un trastorno de la emisión de la saliva consistente en un exceso de producción o en la incapacidad de retención intraoral y deglución de la misma. Esta condición es normal en niños hasta los 15-18 meses de edad y se considera patológica cuando ocurre después de los cuatro años. La causa más frecuente de la sialorrea en los pacientes pediátricos es la disfunción neuromuscular, debido a problemas en la coordinación neuromuscular y en la deglución. Es especialmente prevalente en pacientes con parálisis cerebral infantil (PCI).Desde el punto de vista clínico, los pacientes pueden presentar alteraciones cutáneas peribucales y en la región mentoniana, pobre higiene oral con mayor incidencia de caries dentales y un mayor riesgo de aspiraciones con posibles neumonías asociadas. Así mismo, puede conducir a alteraciones psicológicas y sociales en la vida diaria de los enfermos y familiares. El impacto de la sialorrea en la calidad de vida del paciente es el factor más importante para definir la necesidad de tratamiento..., Salivation is a physiological process dependent on the salivary glands. At rest, 70% of saliva is secreted by the submaxillary glands. However, under stimulation, salivary flow increases, up to five times, with the parotid gland being primarily responsible.Sialorrhoea is defined as a saliva emission disorder consisting of excess saliva production or the inability to retain saliva intraorally and swallow it. This condition is normal in children up to 15-18 months of age and is considered pathological when it occurs after the age of four years.The most common cause of sialorrhoea in paediatric patients is neuromuscular dysfunction, due to problems in neuromuscular coordination and swallowing.It is especially prevalent in children with cerebral palsy (CP).From a clinical point of view, patients may present peribuccal and chin region skin alterations, poor oral hygiene with a higher incidence of dental caries and a higher risk of pneumonia associated with aspiration mechanisms. It can also lead to psychological and social disturbances in the daily lives of patients and their families. The impact of hypersalivation on the patient's quality of life is the most important factor in defining the need for treatment...

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be consid, Depto. de Medicina, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Medication-related osteonecrosis of the jaw (MRONJ) has been associated with the use of different drugs administered in the treatment of malignant neoplasms or metastases and in antiresorptive therapies. Since 2010, denosumab, a monoclonal antibody whose mechanism of action is to prevent the activation of the RANK receptor on the surface of osteoclasts, has been associated with osteonecrosis of the jaw. Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare neoplasm characterised by the presence of squamous cells within the maxillary or mandibular bone without an initial clinical association with the oral mucosa. We present a case of a PIOSCC in an osteonecrosis of the jaw related to a patient who received antiresorptive treatment with denosumab outlining the clinical and histopathological features of MRONJ and PIOSCC., Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Purpose Oncological patients who undergo bilateral subtotal maxillectomies develop functional and esthetic sequelae that require immediate reconstruction. The purpose of this study is to evaluate the primary reconstruction of maxillary defects with fibula flap and dental implants assisted by virtual surgical planning (VSP) and to assess the postoperative outcomes compared with standard surgery. Material and Methods A retrospective study was designed between January 2016 and April 2020 with 12 oncologic patients who underwent subtotal bilateral maxillectomy. Six consecutive patients were treated by standard surgical procedure (SS) at the beginning of the study. In 2018, the VSP was implemented, and 6 consecutive patients were treated using this technique. All patients were rehabilitated with Ticare implants and implant prostheses. Anatomic position of the bone, bone apposition, change of vertical distance, and horizontal shift, the operative and ischemia time, the esthetic results, and the functional rehabilitation were evaluated and compared. Results The position of the bone in anatomical position was 100% in the VSP group vs 66% in the SS group. The bone apposition was 100% in the VSP group vs 83.3%. The change of vertical distance and the horizontal shift were lower in the VSP group (P < .05). The ischemia time and operative time were shorter in the VSP group (P < .05). A good esthetic result was achieved in 83.3% in the VSP group vs 33.3% in the SS group; 81 dental implants and 1 zygomatic implant were placed. The success rate was 95% in the VSP group and 92.6% in the SS group. All patients were rehabilitated with implant prosthesis. Conclusions VSP improves the accuracy of midface reconstruction (class IIC defect) with a better anatomical position of the bone, a higher rate of bone contact, and a lower change in vertical distance compared with standard surgery. It significantly improves the esthetic result, reduces ischemia time, and operation time., Depto. de Cirugía, Fac. de Medicina, TRUE, pub

La salivación es un proceso fisiológico dependiente de las glándulas salivales. En reposo, el 70% de la saliva es secretada por las glándulas submaxilares. Sin embargo, bajo estimulación, el flujo salival aumenta, hasta cinco veces, siendo la glándula parótida la principal responsable. La sialorrea se define como un trastorno de la emisión de la saliva consistente en un exceso de producción o en la incapacidad de retención intraoral y deglución de la misma. Esta condición es normal en niños hasta los 15-18 meses de edad y se considera patológica cuando ocurre después de los cuatro años. La causa más frecuente de la sialorrea en los pacientes pediátricos es la disfunción neuromuscular, debido a problemas en la coordinación neuromuscular y en la deglución. Es especialmente prevalente en pacientes con parálisis cerebral infantil (PCI).Desde el punto de vista clínico, los pacientes pueden presentar alteraciones cutáneas peribucales y en la región mentoniana, pobre higiene oral con mayor incidencia de caries dentales y un mayor riesgo de aspiraciones con posibles neumonías asociadas. Así mismo, puede conducir a alteraciones psicológicas y sociales en la vida diaria de los enfermos y familiares. El impacto de la sialorrea en la calidad de vida del paciente es el factor más importante para definir la necesidad de tratamiento...

Se define como lengua oral a los dos tercios anteriores del órgano lingual siendo importante diferenciarla de la base lingual, la cual forma parte de la orofaringe. Este matiz es importante puesto que el estadiaje, las vías de diseminación y el tratamiento de los tumores que asientan en estas localizaciones difiere entre ambas regiones anatómicas. El carcinoma epidermoide (CE) de cavidad oral representa el 3% de todos los tumores malignos del organismo siendo más frecuente en pacientes varones mayores de 65 años. La tasa de incidencia y mortalidad por cada 100.000 habitantes es de 8,3 y 2,8 en Europa y de 9,3 y 2,4 en España. La supervivencia relativa europea está en el 71% y 46% al año y a los 5 años respectivamente. Las formas de presentación clínica del CE lingual suelen ser mediante úlceras, lesiones exofíticas o neoplasias submucosas considerándose una forma infiltrativa cuando el carcinoma invade más de 1mm en profundidad desde la membrana basal...

Se define como lengua oral a los dos tercios anteriores del órgano lingual siendo importante diferenciarla de la base lingual, la cual forma parte de la orofaringe. Este matiz es importante puesto que el estadiaje, las vías de diseminación y el tratamiento de los tumores que asientan en estas localizaciones difiere entre ambas regiones anatómicas. El carcinoma epidermoide (CE) de cavidad oral representa el 3% de todos los tumores malignos del organismo siendo más frecuente en pacientes varones mayores de 65 años. La tasa de incidencia y mortalidad por cada 100.000 habitantes es de 8,3 y 2,8 en Europa y de 9,3 y 2,4 en España. La supervivencia relativa europea está en el 71% y 46% al año y a los 5 años respectivamente. Las formas de presentación clínica del CE lingual suelen ser mediante úlceras, lesiones exofíticas o neoplasias submucosas considerándose una forma infiltrativa cuando el carcinoma invade más de 1mm en profundidad desde la membrana basal..., Oral tongue is defined as the anterior two thirds of the lingual organ, being important to differentiate it from the tongue base, which is part of the oropharynx. This nuance is important since the staging, dissemination vias and treatment of tumors that settle in these locations differ between both anatomical regions.Squamous cell carcinoma (SCC) of the oral cavity represents 3% of all malignant tumors in the body and is more frequent in male patients over 65 years of age. The incidence and mortality rate per 100,000 inhabitants is 8.3 and 2.8 in Europe and 9.3 and 2.4 in Spain. The relative survival rate in Europe is 71% and 46% per year and 5 years respectively.The clinical presentation of tongue SCC is usually through ulcers, exophytic lesions or submucosal neoplasms. It is considered an infiltrative tumor when carcinomas depth of invasion is more than 1mm deep from the basal membrane...

Double-barrel flap, vertical distraction and iliac crest graft are used to reconstruct the vertical height of the fibula. Twenty-four patients with fibula flap were reconstructed comparing these techniques (eight patients in each group) in terms of height of bone, bone resorption, implant success rate and the effects of radiotherapy. The increase in vertical bone with vertical distraction, double-barrel flap and iliac crest was 12.5 ± 0.78 mm, 18.5 ± 0.5 mm, and 17.75 ± 0.6 mm, (p < 0.001). The perimplant bone resorption was 2.31 ± 0.12 mm, 1.23 ± 0.09 mm and 1.43 ± 0.042 mm (p < 0.001), respectively. There were significant differences in vertical bone reconstruction and bone resorption between double-barrel flap and vertical distraction and between iliac crest and vertical distraction (p < 0.001). The study did not show significant differences in implant failure (p = 0.346). Radiotherapy did not affect vertical bone reconstruction (p = 0.125) or bone resorption (p = 0.237) but it showed higher implant failure in radiated patients (p = 0.015). The double-barrel flap and iliac crest graft showed better stability in the height of bone and less bone resorption and higher implant success rates compared with vertical distraction. Radiation therapy did not affect the vertical bone reconstruction but resulted in a higher implant failure., Depto. de Cirugía, Fac. de Medicina, TRUE, pub, Descuento UCM

Roughness characteristics play an essential role in osseointegration. However, there is a concern about the susceptibility of those surfaces to bacterial colonization. New techniques for cleaning and surface treatment have appeared that could favor osseointegration without the need to create surfaces as rough. Such is the case of non-thermal low-pressure argon plasma (NTLP-ArP). One hundred and forty-four implants were placed in the tibiae of 36 Sprague Dawley rats, distributed in four experimental groups: I: mechanized surface; II: mechanized surface treated with NTLP-ArP, III: resorbable blast media (RBM) surface; and IV: RBM surface treated with (NTLP-ArP). Bone-to-implant contact (BIC) percentages were calculated by microtomographic evaluation and histological analysis at one, two, and four weeks after implant placement. ANOVA and Mann–Whitney tests were used for statistical analysis, establishing p < 0.05. No significant differences were found at one-week comparisons. The groups treated with NTLP-ArP obtained higher BIC% than those not treated at two and four weeks. Mechanized surfaces treated with NTLP-ArP obtained BIC values similar to RBM surfaces