Diagnosis, treatment and maxillofacial rehabilitation in rhinocerebral mucormycosis patient: A case report and review of the literature.

Mucormycosis is an aggressive, rare and opportunistic infectious disease, with a high mortality rate. Etiologic agents are filamentous fungi, and infection among humans normally occurs through spore inhalation. A 61-year-old male individual, presenting left eye amaurosis, dark epistaxis, hyperalgesia and malodor underwent clinical examination, which detected ulcerative lesion and wide bone exposure in the hard palate and alveolar ridge. Direct microbiological examination, microbiological culture and lesion biopsy were performed. Non-septate smooth fungal hyphae forming right angles with each other were observed through the direct microbiological examination. Microbiological culture revealed fast-growing fungal colonies with cottony texture, identified as Rhizopus sp. Histopathological examination exhibited necrosis areas, intense mononuclear inflammatory infiltrate and bulky hyphae, thus concluding the mucormycosis diagnosis. Amphotericin B antifungal therapy and surgical intervention were adopted as treatment. The patient was then rehabilitated with maxillofacial prosthesis, subsequently to the healing of the surgical wound.

Preparation, Antimicrobial Properties, and Cytotoxicity of Acrylic Resins Containing Poly(diallyldimethylammonium chloride).

PURPOSE: To design and analyze the biologic properties (antibacterial and antifungal, as well as cytotoxicity) of a dental biomaterial based on incorporation of the biocide poly(diallyldimethylammonium chloride) (PDADMAC) into the masses of self- and thermopolymerizable acrylic resins. MATERIALS AND METHODS: PDADMAC was diluted into tetrahydrofuran (4 wt%) and incorporated into self- and thermopolymerizable acrylic resins. PDADMAC inclusion was verified by measuring the contact angle with water droplets. Plain resins were used as controls. The antibacterial activity was evaluated against Staphylococcus aureus (ATCC 6538P) and Escherichia coli (ATCC 8739), and the antifungal activity was tested against Candida albicans (ATCC 10231) and Aspergillus niger (ATCC 16404). The cytotoxicity of substances leached from these materials was analyzed in human dental pulp stem cells using MTT reduction assay. RESULTS: Reduction of contact angle confirmed the incorporation of PDADMAC in the resins. Both resins containing PDADMAC were more effective against Gram-positive and Gram-negative bacteria than their controls. The modified resins were also significantly more effective against Candida albicans than controls, but no resin was effective against Aspergillus niger. The cell viability of cultures submitted to substances leached from the PDADMAC resins was similar to that of cells cultured under ideal conditions. CONCLUSION: The incorporation of PDADMAC into the acrylic resins achieved the desired antibacterial effect, with no changes in the biocompatibility properties of the resins. Moreover, the modified resins were effective against Candida albicans, the most common fungus in the oral cavity. Thus, the incorporation of PDADMAC in biomaterials seems to be promising in dentistry.

Oral leishmaniasis: Report of two cases.

Leishmaniasis is a chronic inflammatory disease caused by several species of the parasite Leishmania that is transmitted by insects of the genus Phlebotomus spp. or Lutzomyia spp. This disease can affect skin, mucous membranes and viscera being classified as cutaneous, mucocutaneous and visceral leishmaniasis, depending on the spectrum of clinical manifestations. Diagnosis can be achieved through biopsy, microscopical analysis, Montenegro intradermoreaction and/or ELISA. The dentist plays an important role in the diagnosis of this disease due to frequent involvement of oral mucosa. This article reports two clinical cases of leishmaniasis with oral mucosa involvement, their diagnosis workup and treatment.