odontogenic

牙源性
  • 文章类型: Case Reports
    成釉细胞癌是一种罕见的恶性牙源性肿瘤,可进一步分为原发性或继发性,源于先前存在的良性成釉细胞瘤。它影响了三分之二的患者的下颌骨。该病变没有标准的治疗方案,但在大多数情况下,有或没有放射治疗的根治性手术切除报告。在本文中,我们介绍了一例22岁的男性,诊断为下颌骨成釉细胞癌,具有典型的侵袭性和广泛破坏的临床过程。切开的活检的组织病理学检查显示,角化的复层鳞状上皮具有潜在的纤维结缔组织基质。基质是高度粘液瘤,并表现出牙源性上皮岛和慢性炎症细胞浸润。牙源性上皮的交错链显示星状网状细胞和偶尔的鳞状化生区域,具有细胞和核多态性。此外,注意到有丝分裂图。与临床的相关性,射线照相,和组织学特征,该病变被诊断为成釉细胞癌。手术切除病灶,治疗后随访6个月,未发现恶性肿瘤复发。
    Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. There is no standard treatment protocol for this lesion but radicalsurgical excision with or without radiotherapy is reported in the majority of cases. In this paper, we present a case of a 22 year old male diagnosed with Ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive destruction. Histopathological examination of the incised biopsy showed a parakeratinized stratified squamous epithelium with underlying fibrous connective tissue stroma. The stroma is highly myxomatous and exhibits islands of odontogenic epithelium and chronic inflammatory cell infiltrates. Interlacing strands of odontogenic epithelium shows stellate reticulum-like cells and occasional areas of squamous metaplasia with cellular and nuclear pleomorphism. In addition, mitotic figures were noted. With the correlation of clinical, radiographic, and histological features, the lesion is diagnosed as ameloblastic carcinoma. The lesion was surgical excised and post-treatment follow-up for 6 months revealed no recurrence of the malignancy.
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  • 文章类型: Case Reports
    面部坏死性筋膜炎(NF)是一种罕见但严重的疾病,需要及时和全面的治疗。这种方法通常涉及各种医学专业的输入,如传染病专家,重症监护医生,还有外科医生.首要目标是尽早承认,积极的手术清创术,适当的抗生素治疗,和支持性护理。及时诊断至关重要,根据剧烈疼痛等症状,迅速蔓延的红斑,和全身感染的迹象。广谱抗生素是凭经验启动的,并根据文化结果进行调整。紧急手术清创至关重要,清除所有坏死组织。必须仔细考虑保护重要结构。密切监测和重症监护可能是必要的,特别是对于严重的病例。一旦感染得到控制,可以进行软组织重建,旨在恢复功能和美学。长期随访对观察并发症和复发至关重要。
    Necrotizing fasciitis (NF) of the face is a rare yet serious condition requiring prompt and comprehensive management. This approach typically involves input from various medical specialties such as infectious disease specialists, critical care physicians, and surgeons. The primary goals are early recognition, aggressive surgical debridement, appropriate antibiotic therapy, and supportive care. Prompt diagnosis is crucial, based on symptoms like severe pain, rapidly spreading erythema, and systemic signs of infection. Broad-spectrum antibiotics are initiated empirically, and adjusted based on culture results. Urgent surgical debridement is crucial, removing all necrotic tissue. Careful consideration must be given to preserve vital structures. Close monitoring and intensive care may be necessary, especially for severe cases. Soft tissue reconstruction may follow once the infection is controlled, aiming to restore function and aesthetics. Long-term follow-up is essential to observe for complications and recurrence.
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  • 文章类型: Journal Article
    引言药物相关性颌骨坏死(MRONJ)由牙源性感染发展。然而,也有一些MRONJ从没有牙齿的部位发育的病例,无根管病变,或者没有牙周病.本研究旨在回顾性回顾MRONJ病例的影像学图像,并检查怀疑与牙齿感染有关的MRONJ(牙源性MRONJ)和没有牙齿受累或原因不明的MRONJ(非牙源性MRONJ)之间的特征差异。材料与方法在关西医科大学医院和关西医科大学医学中心诊断为MRONJ的一百四十五名患者。调查了以下变量:性别,年龄,原发疾病,MRONJ网站,身体质量指数,吸烟习惯,糖尿病,皮质类固醇,类型的抗吸收剂,管理期间,CT检查结果(分离死核,骨质溶解,骨膜反应,和骨硬化),触发器,白细胞,中性粒细胞,中性粒细胞-淋巴细胞比率,血清白蛋白,和血清肌酐水平.结果在单变量分析中,在原发疾病为恶性肿瘤的患者中发现牙源性和非牙源性MRONJs之间存在显着差异,接收denosumab(DMB),并且抗吸收剂的给药时间短,没有骨质溶解,骨膜反应,和血清肌酐水平.在多变量分析中,非牙源性MRONJ在无骨质溶解和有骨膜反应的患者中更为常见.结论非牙源性MRONJ在接受大剂量DMB治疗的患者中更易发生,无骨质溶解或骨膜反应的非溶骨性MRONJ病例明显增多。
    Introduction Medication-related osteonecrosis of the jaw (MRONJ) develops from odontogenic infection. However, there are also some cases of MRONJ developing from sites with no teeth, no root canal lesions, or no periodontal disease. This study aimed to retrospectively review radiographic images of MRONJ cases and examine the differences in characteristics between MRONJ suspected to be related to dental infection (odontogenic MRONJ) and MRONJ that occurred without dental involvement or of unknown cause (non-odontogenic MRONJ). Materials and methods One hundred and forty-five patients were diagnosed with MRONJ at Kansai Medical University Hospital and Kansai Medical University Medical Center. The following variables were investigated: sex, age, primary disease, MRONJ site, body mass index, smoking habit, diabetes, corticosteroids, type of antiresorptive agent, administration period, CT findings (separation of sequestrum, osteolysis, periosteal reaction, and osteosclerosis), trigger, leukocytes, neutrocytes, neutrophil-lymphocyte ratio, serum albumin, and serum creatinine levels. Results In the univariate analysis, significant differences between odontogenic and non-odontogenic MRONJs were found in patients whose primary disease was malignancy, receiving denosumab (DMB), and with short administration period of antiresorptive agent, no osteolysis, periosteal reaction, and serum creatinine level. In multivariate analysis, non-odontogenic MRONJ was significantly more common in patients with no osteolysis and with periosteal reaction. Conclusion Non-odontogenic MRONJ tends to occur more frequently in patients treated with high-dose DMB, and there were significantly more cases of non-osteolytic MRONJ without radiographic evidence of osteolysis or with periosteal reactions.
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  • 文章类型: Journal Article
    目的:确定哪些类型的骨病变(针状,小叶,上颌窦中的多孔骨)表明鼻窦炎方法:邻近的牙齿疾病是上颌窦炎的原因;如果病变类型表明鼻窦炎,则与不表明鼻窦炎的病变类型相比,在患病的上颌后牙上应该更常见。研究样本是英国中世纪人类骨骼收藏。
    结果:上颌窦的多孔骨病变(主要是新骨沉积)与邻近的牙齿疾病有关;窦中的骨针/小叶则不相关。
    结论:结果支持多孔病变表明鼻窦炎,但针状/小叶可能并非如此。针状体,在生物文化研究中,应分别分析上颌窦内的小叶和多孔病变;谨慎的做法是仅将多孔病变视为鼻窦炎的指示。
    结论:上颌窦炎通常被用作古病理学的健康指标,针状沉积物通常是最常见的改变类型。通过假设它们是鼻窦炎的指示,我们可能在过去大大高估了骨性鼻窦炎的患病率。
    结论:这些结论是暂时的。关于更大的进一步工作,更多样化的样本,与更详细的解剖研究一起病变的位置和结构正在进行中。
    OBJECTIVE: To determine which types of bone lesion (spicules, lobules, porous bone) in the maxillary sinus indicate sinusitis METHODS: Subadjacent dental disease is a cause of maxillary sinusitis; if a lesion type indicates sinusitis it should be more common above diseased posterior maxillary teeth than a lesion type that is not indicative of sinusitis. The study sample is a British Mediaeval human skeletal collection.
    RESULTS: Porous bone lesions (chiefly new bone deposits) in maxillary sinuses are associated with subadjacent dental disease; spicules/lobules of bone in the sinus are not.
    CONCLUSIONS: The results support the idea that porous lesions indicate sinusitis but the spicules/lobules may not. Spicules, lobules and porous lesions within the maxillary sinus should be analysed separately in biocultural studies; it would be prudent to regard only the porous lesions as indicative of sinusitis.
    CONCLUSIONS: Maxillary sinusitis is commonly used as a health indicator in palaeopathology, and spicular deposits are generally the most common type of alterations. By assuming that they are indicative of sinusitis we may have been greatly overestimating the prevalence of bony sinusitis in the past.
    CONCLUSIONS: These conclusions are provisional. Further work on larger, more diverse samples, together with more detailed anatomical studies on lesion location and structure is ongoing.
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  • 文章类型: Journal Article
    牙槽脓肿是牙齿或周围牙槽骨内的局部感染,通常是由于未经治疗的龋齿或牙齿创伤导致牙槽骨吸收甚至损失。由牙脓肿的传播引起的严重后果通常会导致显著的发病率和死亡率。急性牙槽脓肿是一种多微生物感染,包括严格的厌氧菌,如厌氧球菌,普氏梭菌物种,和兼性厌氧菌,即,弧菌链球菌和强肌链球菌。此外,不适当管理的牙齿感染可发展为严重的颌下间隙感染,并伴有严重的并发症。如败血症和气道阻塞。1999年至2004年对赫尔皇家医院的审计显示,接受口腔颌面外科服务的败血症患者人数有所增加。因此,科学界被迫将重点放在治疗牙槽骨脓肿(DAA)和其他相关牙科问题的治疗策略上.目前的治疗包括抗生素治疗,包括β-内酰胺类药物和非β-内酰胺类药物,但由于不适当和广泛的使用,它导致了抗性微生物的发展。此外,目前使用的β-内酰胺治疗剂是非特异性的并且容易被β-内酰胺酶水解。因此,该研究集中在非β-内酰胺类,它们可能是潜在的药效团,有助于DAA的管理,因为在牙科中适当使用和选择抗生素在抗生素管理中起着重要作用。选择的新目标是NLRP炎性体,这是涉及牙齿问题的主要化学介质。本文就牙槽炎的发病机制及治疗方法作一综述。
    Dentoalveolar abscesses are localized infections within the tooth or the surrounding alveolar bone, often resulting from untreated dental caries or dental trauma causing alveolar bone resorption or even loss. Serious consequences arising from the spread of a dental abscess can often lead to significant morbidity and mortality. The acute dentoalveolar abscess is a polymicro-bial infection comprising strict anaerobes, such as anaerobic cocci i.e., Prevotella fusobacterium species, and facultative anaerobes i.e., Streptococci viridians and Streptococcus anginosus. Moreover, inappropriately managed dental infections can progress to severe submandibular space infections with associated serious complications, such as sepsis and airway obstruction. An audit of the Hull Royal Infirmary between 1999 and 2004 showed an increase in the number of patients presenting to oral and maxillofacial surgery services with dental sepsis. Thus, the scientific com-munity is forced to focus on treatment strategies for the management of dentoalveolar abscess (DAA) and other related dental problems. The current treatment includes antibiotic therapy, including β-lactams and non-β- lactams drugs, but it leads to the development of resistant micro-organisms due to improper and wide usage. Furthermore, the currently used β-lactam therapeutics is non-specific and easily hydrolyzed by the β-lactamase enzymes. Thus, the research focused on the non-β-lactams that can be the potential pharmacophore and helpful in the management of DAA, as the appropriate use and choice of antibiotics in dentistry plays an important role in antibiotic stewardship. The newer target for the choice is NLRP inflammasome, which is the major chemical mediator involved in dental problems. This review focused on pathogenesis and current therapeutics for the treatment of dentoalveolar abscesses.
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  • 文章类型: Case Reports
    牙源性粘液瘤(OMs)代表无症状,具有侵袭性生物学行为的缓慢扩张的颌骨病变。尽管OMs的光谱仍然是经典的,具有多房性射线可透性,并且存在嵌入粘液样基质中的星状细胞,它们可能在影像学或组织病理学上模仿许多其他病变。我们在此讨论一名28岁女性的OM病例,特别强调发病机理和鉴别诊断。
    Odontogenic myxomas (OMs) represent asymptomatic, slowly expanding gnathic lesions with aggressive biological behaviour. Though the spectrum of OMs remains classical with multilocular radiolucency and presentation of stellate-shaped cells embedded in a mucoid stroma, they may mimic many other lesions radiographically or histopathologically. We hereby discuss a case of OM in a 28-year-old woman with special emphasis on pathogenesis and differential diagnosis.
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  • 文章类型: Journal Article
    背景:无论是在神经病学还是牙科,牙源性脑脓肿是一种需要全神贯注的疾病。这种疾病的发作是阴险的,发病率相对较低,但死亡率明显较高。此外,它的症状缺乏特异性,容易导致误诊,监督,治疗延误。因此,面对牙源性致病菌,临床医生应保持高度警惕。
    方法:本文综述了牙源性脑脓肿的临床表现和基本治疗要点的最新研究成果。它可能为及时诊断和改进治疗方法提供重要参考。
    结论:牙源性脑脓肿,脑实质的感染,通常出现在患有牙科疾病或牙科手术后的免疫功能低下的患者中。主要病原微生物包括中间链球菌,具核梭杆菌,硬化链球菌,还有Millella.鉴于患者无法检测到的非特异性症状,诊断过程依赖于微生物学方法。因此,临床医生应积极调查和鉴定牙源性脑脓肿的病原微生物,以便早期发现并选择合适的治疗方案,以避免疾病管理延误。
    BACKGROUND: Whether in neurology or dentistry, odontogenic brain abscess stands as an ailment demanding undivided attention. The onset of this disease is insidious, with a relatively low incidence rate but a markedly high fatality rate. Moreover, its symptoms lack specificity, easily leading to misdiagnosis, oversight, and treatment delays. Hence, clinicians should maintain heightened vigilance when faced with pathogenic bacteria of dental origin in patients.
    METHODS: This paper encapsulates the latest research findings on the clinical manifestations and essential treatment points of odontogenic brain abscess. It may offer a crucial reference for prompt diagnosis and improved therapeutic approaches.
    CONCLUSIONS: Odontogenic brain abscess, an infection of the cerebral parenchyma, usually appears in immunocompromised patients with dental ailments or postdental surgeries. The main pathogenic microorganisms include Streptococcus intermedius, Fusobacterium nucleatum, Streptococcus anginosus, and Millerella. Given the undetectable and nonspecific symptoms in patients, the diagnostic process relies on microbiological methods. Therefore, clinicians should actively investigate and identify the pathogenic microorganisms of odontogenic brain abscess for early detection and selection of appropriate treatment regimens to avoid disease management delays.
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  • 文章类型: Journal Article
    犬的成釉细胞瘤通常具有高度保守的棘皮瘤细胞形态,被认为是犬棘皮瘤成釉细胞瘤(CAA),而常规成釉细胞瘤(CA)构成了较小但形态多样的上皮牙源性肿瘤组。在人类中,一种罕见的促纤维化组织学亚型具有独特的临床,放射学,微观特征。促纤维化成釉细胞瘤(DA)以前没有在狗中描述过,尽管它在兽医文献中很少被引用。这是对狗DA病例系列的首次全面描述,并描述了临床表现,诊断成像结果,诊断的组织病理学特征,和治疗结果。临床上,DA通常表现为中年至老年犬的头骨下颌骨或上颌骨中的肿块或肿胀。关于诊断成像,病变具有射线可透或混合模式,边界明确且位置可变。作为一个固体,牙源性上皮模糊的纤维瘤,DA在组织学诊断方面具有挑战性,并且可以模拟其他几种口腔肿瘤,良性和恶性。作为成釉细胞瘤,DA的生物学行为具有局部破坏性,但良性,手术切除后预后良好。
    Ameloblastoma in dogs most often has a highly conserved acanthomatous cell morphology and is recognized as canine acanthomatous ameloblastoma (CAA) while conventional ameloblastoma (CA) makes up a smaller yet morphologically diverse group of epithelial odontogenic tumors. In humans, a rare desmoplastic histological subtype has distinctive clinical, radiological, and microscopic features. Desmoplastic ameloblastoma (DA) has not previously been described in dogs, although it has been rarely referenced in the veterinary literature. This is the first thorough description of a case series of DA in dogs and describes clinical presentation, diagnostic imaging findings, histopathological features for diagnosis, and treatment outcome. Clinically, DA most often presents as a mass or swelling in the rostral mandible or maxilla of middle age to older dogs. On diagnostic imaging, the lesion has a radiolucent or mixed pattern with well-defined borders and variable loculation. As a solid, fibrous tumor with obscured odontogenic epithelium, DA is challenging to diagnose histologically and can mimic several other oral tumors, both benign and malignant. As an ameloblastoma, the biological behavior of DA is locally destructive yet benign and prognosis is favorable following surgical excision.
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  • 文章类型: Case Reports
    牙源性肉瘤极为罕见,占所有颌面肉瘤的不到5%。它通常影响年轻人口。后下颌骨是最常见的受累部位。射线照相,它似乎是一个大的破坏性射线可透损伤,边缘不明确。组织病理学诊断通常很困难。手术是主要的治疗方法。化疗和放疗的作用尚不清楚。这里,我们提供了一个30岁的女性患者的案例研究,该患者被诊断患有牙源性肉瘤,并侵犯了她的气道。将详细讨论治疗和术后过程。
    Odontogenic sarcomas are exceedingly rare and account for less than 5% of all Maxillofacial Sarcomas. It usually affects the younger population. The posterior mandible is the most commonly affected site. Radiographically, it appears as a large destructive radiolucent lesion with ill-defined margins. Histopathological diagnosis is usually difficult. Surgery is the mainstay treatment. The role of chemotherapy and radiation therapy is not clear. Here, we present a case study of a 30-year-old female patient diagnosed with odontogenic sarcoma that impinged on her airway. The treatment and postoperative course will be discussed in detail.
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  • 文章类型: Journal Article
    目的:探讨兔牙源性脓肿的流行病学特征。
    方法:72只客户拥有的兔子。
    方法:搜索了一家兽医教学医院的病历数据库,以确定患有牙源性脓肿的兔子,其特征是可触及的面部肿块,并通过CT扫描确认。审查的数据包括年龄,品种,提出投诉,脓肿位置,细菌培养结果,治疗,和结果。
    结果:带耳兔是受影响最常见的品种(20/72[28%]),小型lop兔的代表明显偏高。下颌象限更频繁地受到影响(65/92[71%]),骨髓炎是CT上常见的合并症(53/72[74%])。最常见的需氧和厌氧分离株是链球菌属(17/40[43%])和梭杆菌属(10/22[45%]),分别。在62例接受治疗的病例中,有35例(56%)单独进行了全身抗生素治疗。有记录的分辨率为25%。在62例接受治疗的病例中,有20例(32%)使用抗生素浸泡的纱布进行脓肿包装,并进行全身抗生素治疗。在20例(85%)病例中,有17例记录了使用此治疗方案的牙源性脓肿的解决情况。用于获得感染解决的包装程序数量为4(IQR,3至5)。
    结论:脓肿填塞技术的组合,这避免了大量的手术和拔除相关的牙齿,全身性抗生素治疗可以是一种有效的治疗选择,对于患有可触知的牙源性脓肿的兔子,并且可以获得与更具侵入性的手术治疗相当的高治愈率。不建议单独使用抗生素治疗,因为它有一个低的机会脓肿解决。
    OBJECTIVE: To characterize the epidemiologic features of rabbits with odontogenic abscesses.
    METHODS: 72 client-owned rabbits.
    METHODS: The medical record database of a veterinary teaching hospital was searched to identify rabbits with odontogenic abscesses characterized by a palpable facial mass and confirmed via CT scan. Data reviewed included age, breed, presenting complaint, abscess location, bacterial culture results, treatment, and outcome.
    RESULTS: Lop-eared rabbits were the most common breeds affected (20/72 [28%]), and mini lop rabbits were significantly overrepresented. The mandibular quadrants were more frequently affected (65/92 [71%]), and osteomyelitis was a common comorbidity on CT (53/72 [74%]). The most common aerobic and anaerobic isolates were Streptococcus spp (17/40 [43%]) and Fusobacterium spp (10/22 [45%]), respectively. Systemic antibiotic therapy alone was performed in 35 of 62 (56%) treated cases, with documented resolution in 25%. Abscess packing with antibiotic-soaked gauze in conjunction with systemic antibiotic therapy was performed in 20 of 62 (32%) treated cases. Resolution of the odontogenic abscesses with this treatment protocol was documented in 17 of 20 (85%) cases. The number of packing procedures used to obtain resolution of infection was 4 (IQR, 3 to 5).
    CONCLUSIONS: A combination of the abscess-packing technique, which avoids extensive surgery and extraction of the involved elodont teeth, with systemic antibiotic therapy can be an effective treatment option for rabbits with palpable odontogenic abscesses and can result in a high cure rate comparable to more invasive surgical treatments. Antibiotic treatment alone is not recommended, as it has a low chance of abscess resolution.
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