Angelo Itro

Lower facial contouring with botulinum toxin type A.

The use of botulinum toxin (BoNT) is well established in medical practice. The application of BoNT extends over many indications such as strabismus, blepharospasm, hemifacial spasm, and others. Another indication for the use of BoNT type A is the masseteric muscle hypertrophy to obtain a lower facial contouring. Authors report the treatment of 5 patients with intramuscular injection of BoNT. A high degree of patient and physician satisfaction was noted after the treatment. Authors concluded that BoNT type A can safely be considered as a noninvasive drug treatment for patients with MMH.

Block versus particulate/titanium mesh for ridge augmentation for mandibular lateral incisor defects: clinical and histologic analysis.

The purpose of this study was to clinically, histologically, and immunohistochemically evaluate the quantity and quality of newly regenerated bone by means of direct clinical measuring and biopsy specimens of alveolar ridges augmented by autogenous cortical bone or titanium micromesh-both filled with autogenous particulate bone graft in the anterior jaws. For the preliminary study, 10 alveolar bone defects in five partially edentulous patients (two men and three women), between 19 and 35 years old (mean: 25.4, SD: 5.94) were selected. Bone defects were randomly (coin toss) divided into two groups: A (micromesh) and B (bone block). The donor site was the mandibular symphysis in all cases. On the return appointment, operative grafts appeared well incorporated into the native bone, which suggests that good contact and fit between the graft and the recipient site had been obtained during the first surgery. Histologic investigations confirmed excellent integration and revascularization of the graft in both study groups, with formation of new bone tissue without any relevant inflammation.

Oral self-injuries: Clinical findings in a series of 19 patients

Objectives: Self-injury (SI) is defined as a behavioral disturbance consisting of a deliberate harm to one’s own body without suicidal intent, it is not uncommon and ranges in severity from simple nail-biting to more extreme forms of self-mutilation. The head neck region may be the target of such lesions. SI is associated with several medical conditions, of which it can represent the first clinical sign. Aim of this paper is to describe a series of oral SI, giving special emphasis to the clinical findings, etiology and the management of lesions. Material and Methods: A total of 19 patients with oral SI were prospectively examined; attention was paid to the occurrence and characterization of oral lesions. The management of the lesion also varied depending on the patient medical history, on the etiology of the psychiatric behavior, and on the severity, frequency, and method of inflicting injury. Periodic examinations were performed (after two weeks, three months and six months) and registered. Results: All the patients healed gradually and healing was conditioned by the disease underlying. The treatment consisted of behavior modification in 11 cases, pharmacological treatment in 11 cases, psychotherapy in 2 cases, mouth guard in 9 cases, surgery in 2 cases, extractions in 1 case. Conclusions: Oral SI are uncommon in the clinical practice. They may be associated with a known disease or may be the consequence of this, but often they may be the first sign of a psychiatric disorder. Key words:Oral self-mutilation, self-inflicted lesions, self-injurious behavior, ulcers, Obsessive-Compulsive Disorder, mental retardation.

Prognostic implications of node metastatic features in OSCC: a retrospective study on 121 neck dissections

Lymph node metastases are responsible for shorter survival in oral squamous cell carcinoma (OSCC). The aim of the present study was to assess the node metastasis frequency and survival according to the node metastasis features in 121 neck dissections (NDs) performed for OSCC, identifying evidence-based correlations and contrasts with previous literature. The retrospective study involved 121 patients affected by OSCC who had undergone modified radical ND (MRND) for therapeutic, elective reasons or after intraoperative positivity to metastasis of sentinel lymph nodes (SLN+). Node metastasis frequency and behaviour (typical vs. atypical) and their number and distribution according to pre-surgical cTNM cancer staging were considered and overall survival Kaplan-Meier curves were calculated for each group in order to compare mortality according to ND type (elective, therapeutic, after SLN+), lymph node metastatic pattern (typical or atypical), size (micrometastasis vs. macrometastasis) and number. Results showed statistically significant different overall survival according to pre-surgical staging, number of lymph nodes harvested and intent to surgery. Sentinel lymph node resulted in the sole positive node affected by metastasis in small cT1- cT2/cN0 OSCC and an ND subsequent to its positivity during intraoperative assessment may be considered an overtreatment.

Platelet Gel in a Non-Regenerating Cryosurgery-Induced Skin Wound in an Old Patient: A Case Report

Objective: To report on the clinical benefits of platelet gel application in a non-regenerating skin wound. Clinical Presentation and Intervention: An 84-year-old man presented with a severe wound with a regular circumference in the frontal region which resulted in a complete loss of epidermis and dermis. The skin lesion, induced by cryosurgery used to remove a basal-cell carcinoma, had previously been treated with a dermal substitute application (Integra®). After the failure of the skin graft, the patient was treated using a platelet gel therapeutic protocol which achieved the complete healing of the injured area. Conclusion: This case showed the clinical efficacy of using platelet gel in this elderly patient in whom the dermal substitute graft had been ineffective.

Orthodontic movement of impacted cuspid in fibrodysplastic bone: A case report

A case of orthodontic replacement of impacted cuspid in fibrodysplastic maxillary bone in a 12-year-old girl is reported. Fibrodysplastic bone is classically described as a fibrous bone without osteoblastic rimming. It is well known that orthodontic forces lead to tooth movement through proliferation and increased activity of bone cells (osteoblasts and osteoclasts). The reported case clinically support the latest histological studies suggesting that in fibrodisplastic bone osteoblasts are present but altered in shape and therefore difficult to recognize in sections.