Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report / Actinomicose em maxila de um paciente jovem assintomático: relato de caso incomum

ABSTRACT The aim of this study is to report an unusual case of actinomycosis in the maxilla region of an asymptomatic patient. A 21-year-old white man was referred for the analysis of panoramic radiography and cone beam computed tomography, where it was observed the presence of a hypodense lesion on the left side of the maxilla, which extended from the maxillary left central incisor to the region of the maxillary left second premolar. During intraoral examination, a depression was observed in the hard palate mucosa, as well as a fistula in the alveolar mucosa close to maxillary left central incisor, which had pulp vitality confirmed by thermal tests. A fistulography was performed, with periapical radiography, where it was found that the fistulous path did not originate from the tooth mentioned above. An incisional biopsy was performed for diagnostic purposes. However, given the inconclusive microscopic findings, four months later, a new biopsy was performed. The histopathological examination revealed the presence of a colony of microoganisms with filamentous pattern of radiated rosette, surrounded by polymorphonuclear inflammatory cells. Based on the morphological characteristics, the diagnosis of actinomycosis was established. The treatment was based on antibiotic therapy. Six months after treatment of the infection, no signs of recurrence were observed, and the patient remains in follow-up. Actinomycosis in the maxilla is an uncommon infection with a predilection for males between the ages of 20 and 60, whose treatment is antibiotic therapy associated or not with surgical excision.

RESUMO O objetivo deste estudo é relatar um caso incomum de actinomicose em região de maxila de um paciente assintomático. Um homem de 21 anos, branco, foi encaminhado para análise de radiografia panorâmica e tomografia computadorizada de feixe cônico, onde foi observada a presença de lesão hipodensa do lado esquerdo da maxila, que se estendia da região do incisivo central superior esquerdo ao segundo pré-molar superior esquerdo. Ao exame intrabucal, observou-se depressão na mucosa do palato duro, bem como fístula na mucosa alveolar próxima ao incisivo central superior esquerdo, no qual tinha vitalidade pulpar confirmada pelos testes térmicos. Uma fistulografia com radiografia periapical foi realizada, onde foi observado que o trajeto fistuloso não era originado do dente mencionado anteriormente. Foi realizada biópsia incisional para fins diagnósticos. Porém, diante dos achados microscópicos inconclusivos, quatro meses depois, uma nova biópsia foi realizada. O exame histopatológico revelou a presença de colônia de microrganismos com padrão filamentoso de roseta irradiada, circundado por células inflamatórias polimorfonucleares. Com base nas características morfológicas, foi estabelecido o diagnóstico de actinomicose. O tratamento foi baseado em antibioticoterapia. Seis meses após o tratamento da infecção, não foram observados sinais de recidiva e o paciente permanece em acompanhamento. A actinomicose da maxila é uma infecção incomum, com predileção por pacientes do sexo masculino com idade entre 20 e 60 anos, cujo tratamento é antibioticoterapia associada ou não à excisão cirúrgica.

Psammoma Bodies in a Large Myoepithelioma.

Myoepithelioma is a rare benign tumor of the salivary glands, in which the vast majority of neoplastic cells are myoepithelial. A rare microscopic finding in salivary gland tumors, including myoepitheliomas, is the presence of psammoma bodies (PBs), whose etiology and role in the tumors are uncertain. The objective of this study is to describe the unusual histopathologic findings, such as psammomas, of a large myopephelioma on the palate and the prosthetic restorative treatment performed after resection of the tumor. A 52-year-old woman was referred for evaluation of a tumor-like lesion, of smooth surface and normal mucosal color, measuring approximately 5 cm, on the left side hard palate, which had been identified 4 years earlier. The diagnostic hypothesis was a pleomorphic adenoma (PA), and an incisional biopsy was performed. After histopathologic analysis, a PA was suggested, and surgical resection of the tumor was performed. The histopathologic findings were compatible with myoepithelioma showing numerous calcified basophilic structures compatible with PB. Sixteen months after resection of the tumor, a removable maxillary obturator prosthesis was made because of the communication into oral and nasal cavity due from the surgical procedure. The treatment of choice for myoepithelioma is surgical excision with a nonlesional area margin. In the present report, the authors achieve good postoperative results without recurrences. After installation of the prosthesis, the patient had an excellent adaptation and acceptance, thus restoring her function and psychologic condition.

Modified Micromarsupialization as Treatment of Ranula in a Pediatric Patient.

Ranulas are mucoceles located on the floor of the mouth. The main form of treatment for these lesions is surgical excision, but this can lead to complications such as hemorrhage, recurrence of the lesion, and damage to the lingual nerve. Thus, other therapeutic modalities are indicated, such as modified micromarsupialization, which is a simple technique and not associated with recurrences, and without the need of a new intervention in the postoperative period. An 11-year-old female child, nonwhite, presented with bubble-shaped lesion located on floor of the mouth, on the left side, with exophytic growth, sessile base, bluish coloration, measuring about 4.0 cm in diameter, showing well-defined limits, well-delimited contours and borders, smooth surface, and softened consistency. Under the diagnostic hypothesis of the ranula, a modified micromarsupialization was performed. After 90 days of observation, complete regression and repair of the lesion were observed, without recurrence. Modified micromarsupialization is a simple therapeutic modality, low cost, and well-tolerated by the patient, mainly the pediatric one, being considered very effective in the treatment of lesions of difficult clinical management, as the ranula.

Pleomorphic adenoma of buccal mucosa: a case report and review of the literature.

BACKGROUND: Salivary gland neoplasms are rare, accounting for 3% to 5% of all head and neck tumors, and involvement of the minor salivary glands is uncommon. Pleomorphic adenoma (PA) is the most common benign neoplasm, which mainly affects the parotid gland. However, involvement of the cheek mucosa is very rare. OBJECTIVE: This study reports a case of PA in the cheek mucosa. In addition, the etiopathogenesis, clinical and morphological features and differential diagnoses of PA are discussed, emphasizing the importance of knowledge about the characteristics of this tumor for a correct diagnosis. CASE REPORT: A 50-year-old woman presented with a nodular lesion of endophytic growth in the left cheek mucosa. The lesion was small and well-delimited and had a normal mucosa color and intact surface. An excisional biopsy of the lesion was performed, and the diagnosis was PA. CONCLUSION: Although the occurrence of PA in the minor salivary glands of the cheek mucosa is uncommon, the early establishment of a correct diagnosis and initiation of appropriate treatment are important because they permit effective management of the condition and improvement in the prognosis of patients.

Produção científica em laser / LED na odontologia brasileira no período de 2015 a 2019 / Scientific production in laser / LED in Brazilian dentistry from 2015 to 2019

Objetivo:Investigar o perfil das publicações brasileiras em laser/LED de 2015 a 2019. Métodos: Foi realizado um estudo observacional, por meio de documentação indireta, através da análise dos trabalhos apresentados nas reuniões do SBPqO de 2015 a 2019. Os estudos foram classificados quanto à instituição de ensino dos pesquisadores, estado de origem da pesquisa, especialidade odontológica e tipo de estudo. Resultados: Foram identificados 563 resumos. A maior parte foi concentrada em 2019 (21,7%), sendo os lasers operando em baixa potência os mais utilizados (54,1%). O Estado de São Paulo concentrou a maioria dos resumos (67,3%), com a região Sudeste contendo o maior número de trabalhos (76,9%). Em relação à instituição de ensino, as universidades estaduais produziram a maioria dos estudos (47.8%). A especialidade de Dentística foi a que mais realizou pesquisas em laser/LED (21,7%). A maioria dos resumos (73,7%) era do tipo de pesquisa laboratorial básica. A maioria dos trabalhos selecionados não recebeu apoio financeiro (54,7%). Dentre as agências financiadoras mencionadas, as Fundações de Amparo à Pesquisa foram as mais prevalentes (26,6%). Grande parte dos trabalhos não citou o Comitê de Ética em Pesquisa (97,5%). Houve associação estatisticamente significativa entre as instituições públicas e o recebimento de fomento (p < 0,005). Conclusão: A maior parte dos resumos foi concentrada em 2019, com maior número de pesquisas no Estado de São Paulo, realizadas em instituições Públicas e na especialidade de Dentística. Foi observado um número maior de estudos do tipo laboratorial. Além disso, a maioria dos estudos não recebeu fomento para pesquisa.

Aim: To determine the profile of Brazilian publications in laser/ LED from 2015 to 2019. Methods: A retrospective observational study was conducted, using indirect documentation to analyze the papers presented at SBPqO meetings from 2015 to 2019. Results: 563 abstracts involving the use of laser/LED were evaluated and subsequently classified according to higher education research institution, state where the research was conducted, dental specialty, and type of study. Most of the abstracts involving the laser/LED were concentrated in 2019 (21.7%), with low-power lasers being the most frequently used (54.1%). Most of the abstracts were concentrated in the State of São Paulo (67.3%), with the Southeast region containing the largest number of works (76.9%). Regarding the higher education institution, the state universities produced a larger number of the studies (47.8%). Restorative dentistry was the specialty that most developed studies in the laser/LED area (21.7%). Most abstracts (73.7%) were classified as basic laboratory research. Most of the selected studies received no financial support (54.7%). Among the funding agencies mentioned, the Research Support Foundations were the most prevalent (26.6%). Most studies did not mention the Research Ethics Committee (97.5%). There was a statistically significant association between public institutions and the receipt of funding (p < 0.005). Conclusion: Most of the abstracts were identified in 2019, with a greater number of studies conducted in the State of São Paulo, in state institutions across the country, and in the specialty area of restorative dentistry. Laboratory-type studies were the most prevalent. Moreover, most studies received no funding for research.

Use of erythrocytes in cytotoxicity and toxicity assays of medicinal plant extracts: analysis of their application and bibliometric study / Utilización de eritrocitos en ensayos de citotoxicidad y toxidez de extractos de plantas medicinales: análisis de su aplicación y estudio bibliométrico

Plant species have been used for therapeutic purposes since ancient times and are still in use today since these products represent a source of raw material for the production of phytotherapeutic formulations. Screening and investigation of plants with pharmacological potential require the evaluation of characteristics related to their action, efficacy and safety in different steps. Among these steps, pre- clinical trials are used to evaluate the properties of the test product in in vitro experiments, such as cytotoxicity assays. Within this context, this study consists of a bibliometric analysis of some in vitro cytotoxicity and toxicity assays in erythrocytes used during bioprospecting of medicinal plants. The results demonstrated the wide application of erythrocytes to evaluate the biological effects of medicinal plant extracts. The methods were found to be valid and effective for the preliminary investigation of the in vitro cytotoxicity and toxicity of plant products.

El uso de especies vegetales para fines terapéuticos es una práctica histórica y todavía bastante actual, ya que estos productos pueden representar una fuente de materia prima para la producción de formulaciones fitoterápicas. En investigación de plantas con potencial farmacológico requiere la evaluación de su acción, eficacia y seguridad, a través de diferentes etapas. Entre estas, en los ensayos preclínicos se evalúan las propiedades del producto-prueba en experimentos in vitro, tales como ensayos de citotoxicidad, entre otros. En este aspecto, el presente estudio consiste en un análisis bibliométrico acerca de algunas pruebas de citotoxicidad y toxicidad in vitro en eritrocitos realizados en los ensayos de bioprospección de plantas medicinales. Los resultados evidencian la amplia utilización de eritrocitos para la evaluación de los efectos biológicos de extractos de plantas medicinales, apuntándolos como métodos válidos y eficaces para la investigación preliminar de la citotoxicidad y toxicidad in vitro de productos vegetales.

Clinicopathological and immunohistochemical analysis of spindle cell squamous cell carcinoma of the tongue: a rare case.

Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed. Histopathological analysis showed a proliferation of atypical spindle cells, exhibiting extensive pleomorphism. Tumor cells were positive for vimentin, P53 and alpha-smooth muscle actin, focally positive for epithelial membrane antigen and P63, and negative for pan-cytokeratin (AE1/AE3), CK7, CD138, CD34, CD56, and S-100. The positivity index for Ki-67 was approximately 40%. The diagnosis of spindle cell squamous cell carcinoma was established and the patient was referred to a head and neck surgery service. In the oral cavity, spindle cell squamous cell carcinoma of the tongue is an aggressive variant of squamous cell carcinoma, which usually presents as an exophytic mass located on the tongue of elderly males. Due to its distinct histopathological characteristics, immunohistochemistry is a valuable and helpful tool to establish the diagnosis of spindle cell squamous cell carcinoma of the tongue.

Clinical and histopathological study of actinic cheilitis / Estudo clínico e histopatológico das queilites actínicas

Abstract Introduction Actinic cheilitis is a inflammatory condition affecting mainly the lower lip and it is caused by chronic and excessive exposure of the lips to the ultraviolet radiation in sunlight. Objective Identifying clinical and histopathologic characteristics in 40 cases histopathologically diagnosed as actinic cheilitis. In addition, to investigate possible associations between these aspects. Method Defined as an observational, transversal, retrospective and descriptive study, it registered data regarding age, gender, occupation, symptomatology, records of sun exposure, frequency of sunblock use, tabagism, skin color, clinical aspect and histopathological classification. The data was submitted to the chi square test of Pearson (p<0.05). Result There was a predominance of male gender, leucodermia, and ages ranging between 50 and 60 years. The most common occupation was farming. From our sample, 85% had history of chronic sun exposure, in which 50% reported the use of some type of sunblock and only 25% were smokers. The main clinical condition was non-ulcerated leukoplakia and in the histopathological study, the hyperkeratosis were more common. A correlation between the degree of tissue alteration verified in the histopathological diagnosis and the studied clinical variables was not established (p=0.112). Conclusion The clinical aspect of the wound can conceal tissue alterations in different stages, emphasizing the importance of a premature diagnosis.

Resumo Introdução A queilite actínica e uma condição de natureza inflamatória que acomete o lábio inferior, e é causada pela exposição prolongada e crônica dos lábios à radiação ultravioleta proveniente dos raios solares. Objetivo Identificar as características clínicas e histopatológicas em uma série de 40 casos diagnosticados histopatologicamente como queilite actínica. Além disso, investigar possíveis associações entre estes aspectos. Método Caracterizado como um estudo observacional, transversal, retrospectivo e descritivo. Foram registrados dados a respeito da idade, gênero, ocupação, sintomatologia, histórico de exposição ao sol, uso de proteção solar, tabagismo, cor da pele, aspecto clínico e classificação histopatológica. Os dados foram submetidos ao teste de Qui-Quadrado de Pearson (p<0,05). Resultado Houve uma prevalência do gênero masculino, leucodermas, com faixa etária entre 50 e 60 anos e a ocupação mais presente foi a de agricultor. Da amostra, 85% apresentou histórico de exposição crônica ao sol, onde 50% relatou uso de algum tipo de proteção solar e apenas 25% era tabagista. A principal apresentação clínica foi leucoplasia não ulcerada, e no estudo histopatológico as hiperceratoses foram as mais presentes. Não foi possível correlacionar o grau de alteração tecidual verificada no diagnóstico histopatológico com as variáveis clínicas estudadas (p=0,112). Conclusão Não foi possível correlacionar o grau de alteração tecidual verificada no diagnóstico histopatológico com os aspectos clínicos observados. O aspecto clínico da lesão pode mascarar alterações teciduais em diversos estágios, o que enaltece a importância do diagnóstico precoce.

Clinicopathological and immunohistochemical analysis of spindle cell squamous cell carcinoma of the tongue: a rare case / Análise clinicopatológica e imuno-histoquímica do carcinoma de células escamosas de células fusiformes da língua: um caso raro

ABSTRACT Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed. Histopathological analysis showed a proliferation of atypical spindle cells, exhibiting extensive pleomorphism. Tumor cells were positive for vimentin, P53 and alpha-smooth muscle actin, focally positive for epithelial membrane antigen and P63, and negative for pan-cytokeratin (AE1/AE3), CK7, CD138, CD34, CD56, and S-100. The positivity index for Ki-67 was approximately 40%. The diagnosis of spindle cell squamous cell carcinoma was established and the patient was referred to a head and neck surgery service. In the oral cavity, spindle cell squamous cell carcinoma of the tongue is an aggressive variant of squamous cell carcinoma, which usually presents as an exophytic mass located on the tongue of elderly males. Due to its distinct histopathological characteristics, immunohistochemistry is a valuable and helpful tool to establish the diagnosis of spindle cell squamous cell carcinoma of the tongue.

RESUMO O carcinoma de células escamosas de células fusiformes da língua, é uma variante rara do carcinoma de células escamosas. Este trabalho relata o caso de um paciente do sexo masculino de 64 anos de idade com carcinoma de células escamosas de células fusiformes da língua. Foi feita uma revisão dos aspectos relacionados a etiopatogenia, características clinicopatológicas e imuno-histoquímicas, além do tratamento dessa neoplasia. O paciente procurou atendimento para avaliação de tumefação dolorosa na língua. O exame extraoral revelou linfonodos cervicais submandibulares e cervicais superiores palpáveis. Foi realizada biópsia incisional com base nas hipóteses diagnósticas de carcinoma de células escamosas ou neoplasia maligna de glândula salivar. A análise histopatológica demonstrou proliferação de células fusiformes atípicas, exibindo extenso pleomorfismo. As células tumorais foram positivas para vimentina, p53 e alfa-actina de músculo liso, focalmente positivas para antígeno de membrana epitelial e P63, e negativas para pancitoqueratina (AE1/AE3), CK7, CD138, CD34, CD56 e S-100. O índice de positividade para o Ki-67 foi de aproximadamente 40%. Foi feito o diagnóstico de carcinoma de células escamosas, de células fusiformes, e o paciente foi encaminhado para um serviço de cirurgia de cabeça e pescoço. Na cavidade oral, o carcinoma de células escamosas de células fusiformes da língua, é uma variante agressiva do carcinoma de células escamosas, que geralmente se apresenta como massa exofítica localizada na língua de homens idosos. Devido às suas distintas características histopatológicas, a imuno-histoquímica é uma ferramenta valiosa e útil para estabelecer o diagnóstico de carcinoma de células escamosas de células fusiformes da língua.

Ceratocisto odontogênico em mandíbula: relato de caso / Odontogenic keratocyst in mandible: case report

O ceratocisto odontogênico (CO) é um cisto de origem odontogênica, cujo diagnóstico final é dado com base nos aspectos clínicos, radiográficos e histopatológicos. O tratamento mais comum consiste na enucleação cirúrgica. O objetivo do presente estudo foi relatar um caso de CO em região posterior de mandíbula, abordando as características clínico-patológicas e a terapia para essa lesão. Paciente do sexo feminino, 69 anos de idade, apresentou um tumor, de superfície ulcerada, na região retromolar inferior do lado direito. O exame radiográfico da região afetada revelou a presença de uma imagem radiolúcida com limites bem definidos. Após dois meses da primeira consulta e de ter feito ajuste de sua prótese mal adaptada, a paciente retornou apresentando uma lesão tumoral, sem a presença de úlcera, na mesma região. Sob as hipóteses diagnósticas de CO e de cisto residual, foi realizada biópsia excisional. Os achados histopatológicos foram compatíveis com CO. Dezoito meses após a remoção da lesão, não foram identificados sinais de recidiva. O CO possui achados clínicos e radiográficos característicos, bem como diferentes possibilidades terapêuticas, sendo estas abordagens agressiva ou conservadora. Em todos os casos, faz-se necessário o acompanhamento periódico, considerando as altas taxas de recorrência da doença... (AU)

The odontogenic keratocyst (OK) is a cyst of odontogenic origin, which final diagnosis is given from the clinical, radiological and histopathological findings. The most common treatment is surgical enucleation. The objective of the present study was to report a case of OK in the posterior mandible, approaching the clinicopathological features and treatment for this lesion. A 69-year-old female patient presented a tumor lesion of ulcerated surface in the retromolar region of the right side. Radiographic examination of the affected region revealed the presence of radiolucent image with well-defined limits. After two months of the first appointment and after having made adjustments to her poorly adapted prosthesis, the patient returned presenting a tumor lesion, without the presence of ulcers, in the same region. Under the diagnostic hypotheses of OK and residual cyst, excisional biopsy was performed. The histopathologic findings were consistent with OK. Eighteen months after the removal of the lesion there were not identified clinical and radiographic signs of recurrence. The OK has characteristic clinical and radiographic findings, as well as different therapeutic possibilities, being these approaches aggressive or conservative. In all cases, periodic follow-up is necessary, taking into account the high recurrence rates of the disease... (AU)

Punica granatum Linn. prevention of oral candidiasis in patients undergoing anticancer treatment / Punica granatum Linn. na prevenção da candídiase oral em pacientes que se submetem a tratamento antineoplásico

Introduction: Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck. Studies show that herbal medicine has proven to be a promising alternative for the treatment of candidiasis. Objective: To evaluate the effectiveness of the gel Punica granatum Linn. in the prevention of oral candidiasis in patients undergoing radiotherapy with or without chemotherapy for squamous cell carcinoma of the head and neck, and adverse effects associated with its use. Material and method: It was performed a clinical trial, double blind, in the period 2012-2013, with patients seen at a referral hospital for cancer treatment. The sample consisted of 17 patients who did not have signs nor symptoms of oral candidiasis. These patients were divided into two groups: experimental (n=11): composed of patients who used the gel Punica granatum Linn. 6.25% since the beginning of the anticancer treatment and completed a week after the end of the treatment regimen; control (n=6): for patients who used the gel Miconazol 2%, following the same guidelines of the previous group. Data were tabulated and analyzed using descriptive statistics, the chi-square test and calculation of continuing Yates correction (p<0.05). Result: There was no oral candidiasis in 63.6% of patients in the experimental group and in none of the control group patients. Conclusion: Most patients who used the experimental gel showed no clinical signs of fungal infection, and there was no association of adverse effects.

Introdução: A candidíase oral é considerada uma das complicações da terapia antineoplásica de cabeça e pescoço. Estudos revelam que a fitoterapia vem se mostrando uma alternativa promissora para o tratamento da candidíase. Objetivo: Avaliar a efetividade do gel de Punica granatum Linn. na prevenção da candidíase oral, em pacientes submetidos à radioterapia associada ou não a quimioterapia para tratamento de carcinoma de células escamosas na região de cabeça e pescoço, e efeitos adversos associados ao seu uso. Material e método: Foi realizado um ensaio clínico, duplo cego, no período de 2012 a 2013, com pacientes atendidos em um Hospital de referência para tratamento oncológico. A amostra foi composta por 17 pacientes que não apresentavam os sinais e sintomas de candidíase oral, os quais foram divididos em dois grupos: experimental (n=11): composto por pacientes que utilizaram o gel de Punica granatum Linn. 6,25%, desde o inicio do tratamento antineoplásico e concluído uma semana após o término do esquema terapêutico; controle (n=6): por pacientes que utilizaram o gel de Miconazol 2%, seguindo as mesmas orientações do grupo anterior. Os dados foram tabulados e analisados por meio da estatística descritiva e usado os testes Qui-quadrado e Cálculo da Correção Continuada de Yates (p<0,05). Resultado: Não se observou a candidíase oral em 63,6% dos pacientes do grupo experimental, e em nenhum paciente do grupo controle. Conclusão: A maioria dos pacientes que fizeram uso do gel experimental não apresentaram os sinais clínicos da infecção fúngica, e não houve a associação de efeitos adversos.

Endodontic treatment associated with photodynamic therapy: Case report.

BACKGROUND DATA: The complete elimination of bacteria inside the root canal is a difficult task, and inconsistent removal of the innermost layer of contaminated dentin leaves bacteria behind. PDT is an adjunct to conventional endodontic treatment due to its potential to reduce bacteria and its biocompatibility. OBJECTIVE: Report a case of endodontic treatment associated with Photodynamic Therapy (PDT). STUDY DESIGN/PATIENT AND METHODS: A patient with chronic dentoalveolar abscess with radiolucent lesion next to the apexes of teeth 11 and 21 was submitted to conventional endodontic treatment associated with PDT. The canals were filled after two PDT sessions with an interval of 15days between applications. RESULTS: After six months, total regression of apical periodontitis and no fistula or associated symptoms were observed. CONCLUSIONS: The treatment proposed is a viable option for the clinician as it is easy to perform, has relatively low-cost and allows the improvement of symptoms in a short period of time.

Adenocarcinoma polimorfo de baixo grau de grandes proporções em paciente idoso: relato de caso não usual / Large polymorphous low-grade adenocarcinoma in elderly patient: unusual case report

O adenocarcinoma polimorfo de baixo grau (APBG) é uma neoplasia maligna que ocorre predominantemente em glândulas salivares menores e exibe baixa tendência para o comportamento agressivo e a disseminação metastática. O presente trabalho objetiva relatar um caso de APBG em paciente idoso que se configurou como não usual, especialmente pela grande dimensão apresentada pela lesão. Adicionalmente, serão abordados os principais critérios para um correto diagnóstico diferencial com outras neoplasias de glândulas salivares. Paciente, 92 anos, sexo masculino, tabagista, apresentava um tumor assintomático na região esquerda do palato, recoberto por mucosa de coloração normal com áreas telangiectásicas, medindo aproximadamente 7,4 cm. Sob hipótese diagnóstica de carcinoma mucoepidermoide foi realizada uma biópsia do tipo incisional. Após análise histopatológica, os achados microscópicos foram compatíveis com APBG e o paciente foi encaminhado para o cirurgião de cabeça e pescoço. O APBG é uma neoplasia maligna de glândulas salivares que exibe baixa tendência para o comportamento agressivo e se apresenta, geralmente, como um nódulo indolor. No entanto, como o APBG pode alcançar grandes dimensões, os autores ressaltam a importância de um criterioso diagnóstico deste tumor, a fim de diferenciá-lo de outras neoplasias de comportamento biológico e prognóstico diferentes

Polymorphous low-grade adenocarcinoma (PLGA) is a malignant tumor which occurs predominantly in minor salivary glands and exhibits low tendency for aggressive behavior and metastatic spread. The aim of this paper is to report an unusual case of PLGA in an elderly patient, specially because of the large size of the lesion. Furthermore, the main criteria for differential diagnosis between PLGA and other salivary gland neoplasms will be discussed. A 92-year-old male patient, who was a smoker, presented with an asymptomatic tumor on the left portion of the palate, covered by normal mucosa with telangiectatic areas, measuring about 7.4 cm. The diagnostic hypothesis was mucoepidermoid carcinoma and incisional biopsy was done. Histopathologic features were compatible with PLGA and the patient was referred to the head and neck surgeon. PLGA is a malignant salivary gland neoplasm that exhibits low tendency for aggressive behavior and usually presents as a non-tender nodule. Nevertheless, since PLGA can reach a large size, the authors emphasize the importance of an accurate diagnosis of this tumor in order to differentiate it from other neoplasms with different biological behavior and prognosis

Mucoepidermoid carcinoma of the retromolar region: report of a clinical case / Carcinoma mucoepidermoide em região retromolar: descrição de um caso clínico

Although the number of reported cases is low, mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm in the oral cavity. Its etiology is unknown. Clinically, it is described as a painful or painless swelling most often seen in the palate. Due to its great biological diversity, treatment and prognosis depend on the histological grade, location, and tumor stage. The objective of the present study was to describe a clinical case of mucoepidermoid carcinoma in a Brown female patient aged 45 years. Intraoral physical examination revealed a 1.0 cm diameter, bluish bubble with clear boundaries in the left retromolar region. The bubble had been there for roughly four months. An excisional biopsy was performed to confirm the clinical diagnosis of mucocele. Yellowish mucous leaked during the excision. The anatomical-pathological result was mucoepidermoid carcinoma, after which the patient was referred to a head and neck surgeon. Hence, we emphasize the importance of early diagnosis and proper management of this disease. Even when its clinical appearance is not suggestive of malignancy, mucoepidermoid carcinoma diagnosis should be considered in cases of proliferative oral lesions.

Embora apresente uma casuística baixa, o Carcinoma Mucoepidermoide é a neoplasia maligna de glândula salivar mais observada na cavidade oral. Possui etiopatogenia desconhecida e, clinicamente, apresenta-se como tumefação sintomática ou não, sendo o palato, o sítio de predileção. Em decorrência da sua grande diversidade biológica, o tratamento e prognóstico dependem do grau histológico, da localização e do estágio clínico do tumor. O presente trabalho teve por objetivo descrever um caso clínico de carcinoma mucoepidermoide de uma paciente do gênero feminino, 45 anos de idade, feoderma. O exame físico intraoral evidenciou, em região retromolar esquerda, bolha de limites nítidos, medindo cerca de 1,0 cm de diâmetro, coloração azulada, presente há aproximadamente quatro meses. Diante do diagnóstico clínico de mucocele, foi realizada a biopsia excisional; durante a execução da mesma, observou-se extravasamento de muco amarelado. Após o resultado anatomopatológico de carcinoma mucoepiderrmoide, a paciente foi encaminhada ao cirurgião de cabeça e pescoço. Desta forma, enfatiza-se a importância do diagnóstico precoce e correto manejo desta patologia, que, mesmo quando sua aparência clínica não sugerir malignidade, deve ser considerada como hipótese diagnóstica em lesões proliferativas da boca.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2.

BACKGROUND: Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES: To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS: A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS: The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS: The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2

BACKGROUND: Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES: To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS: A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS: The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS: The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2. .

Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

Introduction: Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective: To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report: An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion: Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site...

Aspectos demográficos e manifestações clínicas bucais de pacientes soropositivos para o HIV/Aids / Demographic and clinical manifestations of oral in patients seropositive for HIV /SIDA

Introdução: As lesões bucais e peribucais são comuns nos pacientes infectados pelo vírus HIV e podem representar os primeiros sinais da doença, antes mesmo das manifestações sistêmicas. Objetivo: Este estudo objetivou estimar a prevalência de manifestações bucais em indivíduos soropositivos para o HIV, considerando aspectos sociodemográficos, imunológicos e terapêuticos. Material e Método: Foi realizado um estudo de natureza clínico-epidemiológica transversal, entre outubro de 2007 e abril de 2008, com amostra composta por 40 pacientes. Utilizou-se a técnica de observação direta intensiva por meio de exame clínico apropriado. Os dados foram registrados em fichas pré-elaboradas e analisados por estatística descritiva e inferencial. Resultado: Verificou-se a prevalência do gênero feminino (52,5%), na faixa etária de 40 a 49 anos (45%). O tratamento com antirretrovirais foi constatado em 85,0% dos casos, sendo todos com terapia de alta potência (HAART). Observou-se que 52,5% dos pacientes apresentaram a contagem de linfócitos TCD4+ acima de 500cél/mm³ e 50,0% apresentaram carga viral indetectável. A prevalência das manifestações bucais foi 42,5%, sendo a mais expressiva a candidose pseudomembranosa (19,23%), seguida da periodontite úlcero-necrosante (15,38%), da leucoplasia pilosa (11,54%) e da queilite angular (11,54%). Não foi verificada associação entre manifestações bucais e carga viral (p=0,1268), nem com o número de células T CD4 (p=0,3458). Conclusão: A prevalência de algumas manifestações bucais associadas à infecção pelo HIV ainda é alta, sendo a candidose pseudomembranosa a infecção mais prevalente, principalmente entre pessoas com baixo nível ...

Introduction: The oral and perioral lesions are common in patients infected with HIV, and may represent the first signs of the disease, even before the systemic manifestations. Objective : This study aimed to estimate the prevalence of oral manifestations in HIV seropositive individuals, considering the aspects socio-demographic, immunological and therapeutic. Material and Method: Was performed nature study clinical-epidemiological transverse, between October 2007 to April 2008, with a sample of 40 patients. Was used the technique of intensive direct observation through appropriate clinical exam. Data were recorded on data sheets pre-prepared and analyzed by descriptive and inferential statistics. Result: There was a prevalence of females (52.5%), aged 40-49 years (45%). Treatment with antiretroviral drugs was found in 85.0% of cases, all being with high power therapy (HAART). It was observed that 52.5% of patients had a TCD4+ lymphocyte count above 500cél/mm ³ and 50.0% had an undetectable viral load. The prevalence of oral manifestations was 42.5%, the most significant for pseudomembranous candidiasis (19.23%), followed necrotizing ulcerative periodontitis (15.38%), hairy leukoplakia (11.54%) and angular cheilitis (11.54%). No association was observed between oral lesions and viral load (p=0.1268) nor the TCD4 cell count (p=0.3458). Conclusion: Prevalence of some oral manifestations associated with HIV infection is still high, with pseudomembranous candidiasis infection more prevalent, mainly among people with low education levels and longer HIV infection, independent of the therapy and immune status of the patient. .

Adenoid cystic carcinoma mimicking an oroantral fistula: a case report.

Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.

Radiographic evaluation of the dental condition of elderly people treated at a Brazilian public university

AIM: To assess the dental status of elderly patients examined in the clinical dentistry course of a Brazilian public university. METHODS: An observational and descriptive study based on the analysis of panoramic radiographs. The sample consisted of 60 elderly patients who met the inclusion criteria. Two observers who had been trained in appropriate conditions performed the radiographic analysis. Data were stored in a specific form, recorded in a database and analyzed using descriptive statistics (measures of central tendency and variability) and inferential statistics (Mann-Whitney U test, Kruskal-Wallis test, Chi-square analysis and calculation of the Cramer's V coefficient). RESULTS: Most patients had at least one tooth in the oral cavity (71.7%), while 28.3% were totally edentulous, an average of 10.5 teeth per individual. The average number of teeth was 11.36 in males and 9.89 in females. The number of healthy teeth was 328 (5.47 per patient). In this study, 88.3% of the subjects had periodontal bone loss, with prevalence of moderate (35.0%) and severe (28.3%) bone loss. CONCLUSIONS: Given the high incidence of edentulous individuals, the high number of restored teeth and poor periodontal conditions, it is concluded that the overall oral health status of the evaluated elderly subjects is poor.