Diagnosis and treatment of oral lichen sclerosus in a pediatric patient.

Lichen sclerosus is an uncommon chronic inflammatory disease, which rarely affects the oral mucosa. Here, we describe the occurrence of oral lichen sclerosus with gingival destruction in a 12-year-old female patient. After diagnostic confirmation by histopathology, intralesional injection of corticosteroid was performed, producing satisfactory remission of the lesion.

Conservative management of multiple odontogenic keratocysts in a child with nevoid basal cell carcinoma syndrome: A case report.

BACKGROUND: Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant multisystemic disorder characterized by the presence of multiple odontogenic keratocysts (OKC), which are a hallmark feature of the syndrome. The treatment of these OKC poses challenges due to their high recurrence rates and the myriad of management options available. CASE REPORT: We describe here a case of NBCCS diagnosed in an 11-year-old girl who presented with multiple OKC in the jaws. Chest and cranial radiographs showed no abnormalities in the ribs and the cerebral falx, respectively. Cephalometric analysis indicated mandibular retrusion, a skeletal class II relationship, and a convex profile. The treatment approach involved a personalized strategy tailored for each cyst, comprising marsupialization followed by enucleation. This approach aimed to minimize surgical trauma and to reduce the risk of recurrence. The patient underwent regular follow-up appointments, demonstrating successful outcomes with no signs of recurrence or de novo OKC observed over a 32-month period. CONCLUSION: Clinicians should consider lesion characteristics and patient cooperation when determining treatment strategies for the optimization of outcomes for children and adolescents with NBCCS and multiple OKC.

Correlation between koilocytes and human papillomavirus detection by PCR in oral and oropharynx squamous cell carcinoma biopsies.

The purpose of this study was to compare the histopathological analysis with polymerase chain reaction (PCR) methods to predict the presence of human papillomavirus (HPV) infection in oral squamous cell carcinoma biopsies. Eighty-three paraffin-embedded tissue specimens from patients with oropharynx and mouth floor squamous cell carcinoma were submitted to histopathological analysis under light microscopy, specifically for the determination of the presence of koilocytes. Subsequently, DNA was purified from the same paraffin-embedded specimens and submitted to PCR. Fisher's exact test showed no statistically significant correlation between the two methods. The results suggest that the presence of koilocytes is unreliable for the detection of HPV presence in oral and oropharynx squamous cell carcinoma.

Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: the importance of ongoing oral examinations.

Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment.

Fluorescence-guided surgical management of medication-related osteonecrosis of the jaws.

Medication-related osteonecrosis of the jaw (MRONJ) results in progressive destruction of the jawbones, and advanced cases demand surgical intervention. The total removal of necrotic bone is required to prevent recurrence and infection. However, determining the limits between necrotic and healthy bone is a challenge. The use of fluorescence to detect tissue alterations and determine necrosis extension is a promising method to avoid inadequate bone debridement. In the literature, there are several studies and reported cases that successfully use fluorescence-guided surgery (FGS) of MRONJ. The objective of this study was to present a critical review of the literature regarding the intraoperative use of optic fluorescence to differentiate healthy and necrotic bone in MRONJ. Studies that evaluated the intraoperative use of optic fluorescence to determine the surgical margins of MRONJ were searched in Pubmed/Medline and Scopus databases using the following terms: "medication-related osteonecrosis of the jaws" and "fluorescence". Eighteen papers describing the intraoperative use of FGS in ONJ management were selected, totalizing 218 patients. Of those 18 papers, only 5 were prospective studies, and the other 13 were isolated case reports, case series, and technical notes. The use of FGS to delimitate the resection margin of MRONJ is a promising method. There is no need for the application of exogenous fluorophore to perform FGS and the most often used light device was the VELScope® system. Further prospective studies with larger samples are still required to ascertain the fluorescence validity as a supporting method in MRONJ surgical treatment and to establish clinical protocols.

History and future perspectives for the use of fluorescence visualization to detect oral squamous cell carcinoma and oral potentially malignant disorders.

The early diagnosis of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is challenging. The use of fluorescence visualization (FV) has been improved as an auxiliary method to early detect alterations in the oral mucosa suggestive of malignancy or pre-malignancy. However, perhaps due to some misinterpretation regarding the clinical purpose of this method, its applicability may have been underestimated. The purpose of this review is to comment on the challenges within the prevention and early diagnosis of OSCC and OPMDs; to contextualize the use of fluorescence-based methods in the diagnosis of human cancers; and to critically analyze the methods and results of studies that evaluated the FV to detect OSCC and OPMDs, and how this method might be applicable in the clinical practice. The current evidence available in the scientific literature indicates that the FV has the potential to improve the early detection of OSCC and OPMDs. Its use in primary healthcare by general practice dentists, oral hygienists, and oral health therapists is recommended, although more research in the population screening scenario is still required.

Fluorescence visualization improves the detection of oral, potentially malignant, disorders in population screening.

BACKGROUND: Scientific literature shows the great potential of fluorescence visualization (FV) in the detection of lesions in the skin and mucosa, though its use has been intermitant. Thus, the aim of this study was to compare the detection of oral cancer and oral potentially malignant disorders (OPMD) with and without the use of fluorescence visualization in population screening. PATIENTS AND METHODS: During a population screening for oral cancer and OPMD, general practice dentists (GPD) performed conventional oral examination (COE) in the first year, and in the second year the FV was inserted in the oral examination. When detecting any suspicious lesion in oral mucosa either by COE or FV, patients were referred for final diagnosis by a specialist in oral medicine. Biopsy was performed in cases of high-risk lesions to confirm the diagnosis, presence of epithelial d (ED), and oral squamous cell carcinoma (OSCC). RESULTS: During the oral cancer prevention campaign in the first year, benign neoplasms were the oral lesions with higher diagnosis rate (26.2%), followed by non-neoplastic proliferative processes (23.8%) and potentially malignant disorders (21.4%). During the second year, with the implementation of the use of FV, OPMD were the lesions with higher diagnosis rate (37.7%). The sensitivity, specificity and accuracy for the detection of potentially malignant disorders were respectively equal to 94.4%, 96.2% and 96.1%. The detection of lesions with epithelial dysplasia for these amounts were respectively equal to 100%, 92.4% and 92.6%. CONCLUSION: FV presented high diagnostic values when used by GPD and improved the detection of OPMD in population screening. FV has potential to be used as an adjunctive method for early diagnosis of oral high-risk lesions.

Tongue metastasis of cutaneous melanoma: Report of two cases and literature review.

INTRODUCTION: Malignant metastases to the oral cavity are rare and metastatic melanomas of the tongue are considered exceptionally uncommon, with less than 10 cases published in the English literature so far. CASE REPORTS: Two female patients in the 7th decade of life presented to our dental service with nodules in the tongue. Both patients had multiple metastases at the time of oral diagnosis and primary melanoma originated on the skin. An intra-oral incisional biopsy was performed under local anesthesia and the histopathologic analysis was characterized by the proliferation of atypical epithelioid cells displaying a poorly delimited cytoplasm and hyperchromatic nucleus which contained eosinophilic macronucleoli. Immunohistochemistry was performed in both cases to confirm the clinical hypothesis of metastatic melanoma. After the diagnosis of oral metastatic melanoma, the patients were maintained under palliative care and close medical follow-up. Both patients died four and a half months and 20 months after the diagnosis of tongue metastasis. CONCLUSIONS: Although rare, metastatic melanoma should be included in the differential diagnosis of tongue lesions detected in patients with a previous medical history of cutaneous melanoma. Key words:Melanoma, tongue, metástases.

Fluorescence visualization efficacy for detecting oral lesions more prone to be dysplastic and potentially malignant disorders: a pilot study.

BACKGROUND: To analyze the efficacy of fluorescence visualization in early detection of oral early neoplastic processes when used by an inexperienced and an adept oral examiner. METHODS: A dental student and an expert professional in oral diagnosis examined 15 randomly selected patients using conventional oral examination and fluorescence visualization searching for early signs of epithelial dysplasia and oral potentially malignant disorders. Patients detected with oral lesions in any of examinations were submitted to incisional biopsy for definitive diagnosis. RESULTS: Taking histopathologic analysis as Gold Standard, sensitivity, specificity, positive and negative predictive values and accuracy of inexperienced examiner for detecting both epithelium dysplasia and oral potentially malignant disorders increased when using fluorescence visualization compared to conventional white light examination, matching the same values found for expert professional in oral diagnosis. Furthermore, it was possible to observe discrete increase in the efficacy of expert professional's examination when using fluorescence visualization. CONCLUSION: This study indicates fluorescence visualization is capable of improve inexperienced professionals' efficacy for early detecting oral lesions more prone to be dysplastic and oral potentially malignant disorders.

Uncommon Occurrence of Lip Squamous Cell Carcinoma in a Pediatric Patient.

Although head and neck squamous cell carcinoma represents one of the most common cancers among adults, it is rare in pediatric patients. The purpose of this report is to discuss the case of a 15-year-old male patient referred by his dentist due to a three-month old ulcer in his lower lip. The patient denied tobacco smoking and drinking alcohol, and confirmed that he performed manual labor in a brick yard, being exposed daily to the sun without protection. Clinical examination revealed an exophytic rounded ulcer in the right lower lip, measuring 1.5 cm, with a flaky bed. An incisional biopsy was performed, and histopathologic analysis confirmed the diagnosis of squamous cell carcinoma. The treatment of choice was surgical excision. Malignancy should be included in the differential diagnosis of chronic oral ulcers in children and adolescents. Moreover, chronic sun exposure might be associated with occurrence of lip squamous cell carcinoma.

Cirurgia parendodôntica como opção para casos especiais: relato de caso / Parendodonic surgery as an option for special cases: case story / Cirugía parendodóntica como opción para casos especiales: relato de caso

A terapia endodôntica consiste em: abertura coronária, modelagem, limpeza, desinfecção, e selamento tridimensional do sistema de canais radiculares. Dentre as etapas constituintes do tratamento, a análise da anatomia interna dos dentes a serem tratados, deve ser cuidadosamente observada e seguir os princípios científicos e biológicos para que sejam minimizadas as possibilidades de falhas e acidentes. Os erros podem ocorrer tanto pela falta de habilidade do profissional, anatomia do elemento a ser tratado ou característica dos instrumentos. Em casos onde há dentes com lesão periapical, por conta de canais calcificados ou obstruídos por instrumentos fraturados, falha do tratamento convencional e impossibilidade de retratamento, é indicada a cirurgia paraendodôntica como opção de tratamento. O objetivo do presente estudo é descrever um relato de caso clínico sobre cirurgia paraendodôntica como tratamento para lesão periapical e manobra cirúrgica para remoção de um instrumento fraturado no terço apical do dente 22. Conclusão: quando o tratamento por via convencional é impossível de ser realizado, a cirurgia paraendodôntica é uma ótima opção de tratamento para dentes com lesões periapicais e para remoção de instrumentos fraturados, sendo uma forma de preservar o órgão dental e evitar extrações preciptadas. No presente estudo foi possível notar radiograficamente a regressão da lesão periapical e clinicamente a ausência de sintomatologia(AU)

The endodontic therapy consists of: coronary opening, modeling, cleaning, disinfection, and three-dimensional sealing of the root canal system. Between the constituent stages of the treatment, the analysis of the internal anatomy of the teeth to be treated, must be carefully observed and follow the scientific and biological principles to minimize the chances of faults and accidents. Errors can occur due to lack of skill of the professional, anatomy of the element to be treated or characteristic of the instruments. In cases where there are teeth with periapical lesions, due to calcified or obstructed channels by fractured instruments, failure of conventional treatment and impossibility of retreatment, paraendodonic surgery is indicated as an option for treatment. The aim of the present study is to describe a clinical case report on para-endodontic surgery as a treatment for periapical injury and surgical maneuver for the removal of a fractured instrument in the apical third of tooth 22. Conclusion: when conventional treatment is impossible to perform, Para-endodontic surgery is an optimal treatment option for teeth with periapical lesions and for the removal of fractured instruments, being a way to preserve the dental organ and avoid precipitated extractions. In the present study it was possible to observe radiographically the regression of the periapical lesion and clinically the absence of symptomatology(AU)

La terapia endodóntica consiste en: apertura coronaria, modelado, limpieza, desinfección, y sellado tridimensional del sistema de canales radiculares. Entre las etapas constituyentes del tratamiento, el análisis de la anatomía interna de los dientes a tratar, debe ser cuidadosamente observado y seguir los principios científicos y biológicos para minimizar las posibilidades de fallas y accidentes. Los errores pueden ocurrir tanto por la falta de habilidad del profesional, anatomía del elemento a ser tratado o característica de los instrumentos. En casos donde hay dientes con lesión periapical, debido a canales calcificados u obstruidos por instrumentos fracturados, falla del tratamiento convencional y imposibilidad de retratamiento, se indica la cirugía paraendodónica como opción de tratamiento. El objetivo del presente estudio es describir un relato de caso clínico sobre cirugía paraendodóntica como tratamiento para lesión periapical y maniobra quirúrgica para remoción de un instrumento fracturado en el tercio apical del diente 22. Conclusión: cuando el tratamiento por vía convencional es imposible de realizar, la cirugía paraendodóntica es una óptima opción de tratamiento para dientes con lesiones periapicales y para remoción de instrumentos fracturados, siendo una forma de preservar el órgano dental y evitar extracciones precipitadas. En el presente estudio fue posible observar radiográficamente la regresión de la lesión periapical y clínicamente la ausencia de sintomatologia(AU)

Oral lesions detected during a population screening for prevention and early diagnosis of oral cancer and potentially malignant disorders / Lesões orais detectadas durante uma triagem populacional para prevenção e diagnóstico precoce de câncer de boca e lesões potencialmente maligniziveis

Objective: In this paper, we describe the results of an oral cancer prevention campaign for early detecting and diagnosing oral cancer and potentially malignant disorder. Subjects and method: The population screening was performed in one day in which population was recruited by local mass media communication means. Patients with suspicious lesions were referred for final diagnosis with a specialist in oral medicine and pathology. Results: Of 1.282 patients screened, 104 were referred for specialized care and 94 attended for final diagnosis. Of those, only one (1.06%) patient was diagnosed with oral squamous cell carcinoma and 25 (26.5%) with oral potentially malignant disorders, while the diagnosis rates for benign conditions and normality variations were, respectively, 78.7% and 32.9%. Conclusion: These results suggest low awareness regarding oral cancer within this population, flaws in the knowledge regarding oral cancer by dentists, and the need for improvements in the access to the at-risk population for oral cancer.(AU)

Objetivo: neste artigo, descrevemos os resultados de uma campanha de prevenção do câncer de boca para detectar e diagnosticar precocemente câncer de boca e lesões bucais potencialmente maligniziveis. Sujeitos e método: uma triagem populacional foi realizada em um dia em que a população foi recrutada por meios de comunicação de mídia local. Pacientes com lesões suspeitas foram encaminhados para diagnóstico final com especialista em Estomatologia e Patologia Bucal. Resultados: dos 1.282 pacientes selecionados, 104 foram encaminhados para atendimento especializado e 94 atendidos para diagnóstico final. Desses, apenas um (1,06%) paciente foi diagnosticado com carcinoma espinocelular de boca e 25 (26,5%) com lesões bucais potencialmente maligniziveis, enquanto as taxas de diagnóstico para condições benignas e variações de normalidade foram, respectivamente, 78,7% e 32,9%. Conclusão: esses resultados sugerem baixa conscientização sobre o câncer bucal nessa população, falta conhecimento sobre o câncer bucal por dentistas e a necessidade de melhorias no acesso à população em risco de câncer bucal.(AU)

Fluorescência óptica no diagnóstico de lesões em colo cervical: revisão de literatura / Optical fluorescence in the diagnosis of cervical colosion injuries: literature review / Fluorescencia óptica en el diagnóstico de lesiones en colo cervical: revisión de literatura

O câncer de colo uterino ainda hoje é um problema de saúde pública em muitas partes do mundo. No Brasil, é o terceiro tumor maligno mais frequente entre as mulheres. Uma das causas pontadas como percussor desse câncer é o HPV, principalmente, quando correlacionado a outros fatores de riscos e estilo de vida. Sua cura é altamente possível desde que se tenha um diagnóstico rápido e preciso. Na maioria dos casos, as alterações celulares no colo uterino são descobertas facilmente no exame preventivo conhecido como Papanicolau. Outro método que pode ser utilizado para esta detecção precoce de lesões em colo cervical é a fluorescência óptica que não é invasivo e vem sendo amplamente utilizado no diagnóstico de lesões bucais e de pele. Dessa forma, o presente trabalho teve como objetivo realizar uma revisão da literatura sobre a aplicação da fluorescência óptica no diagnóstico de lesões em colo cervical(AU)

Cervical cancer is still a public health problem in many parts of the world today. In Brazil, it is the third most frequent malignant tumor among women. One of the leading causes of this cancer is HPV, especially when correlated with other risk factors and lifestyle. Its cure is highly possible as long as you have a quick and accurate diagnosis. In most cases, cellular changes in the cervix are easily discovered in the preventive examination known as Papanicolaou. Another method that can be used for this early detection of cervical lesions is non-invasive optical fluorescence and has been widely used in the diagnosis of oral and skin lesions. Thus, the present work had the objective of reviewing the literature on the application of optical fluorescence in the diagnosis of cervical lesions(AU)

El cáncer de cuello uterino sigue siendo un problema de salud pública en muchas partes del mundo. En Brasil, es el tercer tumor maligno más frecuente entre las mujeres. Una de las causas planteadas como percusión de este cáncer es el VPH, principalmente, cuando está correlacionado con otros factores de riesgo y estilo de vida. Su curación es altamente posible desde que se tenga un diagnóstico rápido y preciso. En la mayoría de los casos, los cambios celulares en el cuello uterino se descubren fácilmente en el examen preventivo conocido como Papanicolaou. Otro método que puede ser utilizado para esta detección precoz de lesiones en cuello cervical es la fluorescencia óptica que no es invasiva y viene siendo ampliamente utilizado en el diagnóstico de lesiones bucales y de piel. De esta forma, el presente trabajo tuvo como objetivo realizar una revisión de la literatura sobre la aplicación de la fluorescencia óptica en el diagnóstico de lesiones en cuello cervical(AU)

Cisto dentígero: diagnóstico e tratamento / Cisto dentígero: diagnosis and treatment / Cisto dentígero: diagnóstico y tratamiento

O cisto dentígero é um cisto odontogênico que é classificado como de desenvolvimento. Normalmente, está relacionado à coroa de um dente incluso, sendo um dos cistos odontogênicos mais frequentes nos ossos gnáticos. Na maioria das vezes é diagnosticado em pacientes entre a segunda e a terceira década de vida, com grande ocorrência em terceiros molares inferiores e caninos superiores. Clinicamente, apresenta evolução lenta, assintomática e pode causar discreta deformidade facial, deslocamento de dentes e alterações de estruturas na região. Radiograficamente, os cistos dentígeros são descritos como lesões radiolúcidas bem delimitadas e uniloculares. Na maioria dos casos, são observados em exames de rotina ou durante a pesquisa da causa da não erupção de um dente permanente. Apesar da singularidade clínica de cada caso, o prognóstico dessa lesão é favorável. O tratamento para o cisto dentígero pode ser a marsupialização em casos de lesões grandes, enucleação com exodontia do dente incluso ou preservação do elemento dental. Este trabalho visa apresentar um caso clínico de cisto dentígero em região posterior de mandíbula, abordando aspectos clínicos, imaginológicos, histopatológicos e terapêuticos, com a finalidade de familiarizar o cirurgião dentista com tal lesão(AU)

The dentigerous cyst is an odontogenic cyst that is classified as developmental cyst. It is usually related to the crown of an included tooth, being one of the most frequent odontogenic cysts in the gnatic bones. Most of the time it is diagnosed in patients between the second and third decade of life, with great occurrence in third molars and upper canines. Clinically, it presents slow evolution, asymptomatic and can cause discreet facial deformity, tooth dislocation and alterations of structures in the region. Radiographically, dentigerous cysts are described as well delimited and unilocular radiolucent lesions. Normally, they are seen in routine examinations or during the investigation of the cause of non-eruption of a permanent tooth. Despite the clinical singularity of each case, the prognosis of this lesion is favorable. The treatment for dentigerous cyst may be marsupialization in cases of large lesions, enucleation with exodontia of the included tooth or preservation of the dental element. This paper aims to present a case report of a dentigerous cyst in the mandible, posterior region, addressing clinical, imaging, histopathological and therapeutic aspects, in order to familiarize the dentist surgeon with such lesion(AU)

El quiste dentígero es un quiste odontogénico que se clasifica como de desarrollo. Normalmente, esta relacionada con la corona de un diente incluido, siendo uno de los quistes odontogénicos más frecuentes en los huesos gnáticos. La mayoría de las veces se diagnostica en pacientes entre la segunda y la tercera década de vida, con gran ocurrencia en terceros molares inferiores y caninos superiores. Clínicamente, presenta evolución lenta, asintomática y puede causar discreta deformidad facial, desplazamiento de dientes y cambios de estructuras en la región. Los cistos dentígeros se describen como lesiones radiolúcidas bien delimitadas y uniloculares. Normalmente, se observan en exámenes de rutina o durante la investigación de la causa de la no erupción de un diente permanente. A pesar de la singularidad clínica de cada caso, el pronóstico de esta lesión es favorable. El tratamiento para el quiste dentígero puede ser la marsupialización en casos de lesiones grandes, enucleación con exodoncia del diente incluido o preservación del elemento dental. Este trabajo pretende presentar un relato de caso clínico de quiste dentígero en mandíbula, región posterior, abordando aspectos clínicos, imaginológicos, histopatológicos y terapéuticos, con la finalidad de familiarizar al cirujano dentista con tal lesión(AU)

Effects of resin luting agents and 1% NaOCl on the marginal fit of indirect composite restorations in primary teeth.

OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1% sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1% NaOCl irrigation+EnForce); G2 (EnForce); G3 (1% NaOCl irrigation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100% relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (α=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1% NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

Diagnóstico e conduta clínica perante dentes supranumerários localizados em pré-maxila: relato de um caso / Diagnosis and clinical approach of supernumerary teeth in anterior maxila: a case report

Dentre os defeitos do desenvolvimento craniofacial, a Hiperdontia representa uma alteração de número do desenvolvimento dentário relevante, devido a sua alta prevalência e ao seu potencial para comprometer funcional e esteticamente os pacientes acometidos. O presente trabalho descreve o caso de um paciente de 5 anos de idade, acometido pelo desenvolvimento de dois elementos dentários supranumerários em região anterior de maxila. O caso foi diagnosticado a partir de avaliação radiográfica associada à erupção ectópica de um dos elementos supranumerários por face palatina dos incisivos superiores decíduos, os quais se apresentavam com mobilidade fisiológica devido ao desenvolvimento de seus sucessores. O tratamento eleito para o caso foi a extração dos elementos decíduos com mobilidade e do elemento supranumerário erupcionado, optando-se pela remoção do elemento supranumerário incluso em momento posterior, uma vez que este não se encontrava associado a nenhum comprometimento funcional ou estético e também pelo fato de que a remoção do mesmo geraria alta morbidade ao paciente pediátrico. O caso descrito salienta a importância do cirurgião no acompanhamento do desenvolvimento craniofacial humano, uma vez que este pode ser acompanhado de distúrbios significativos. Além disso, o presente caso alerta a comunidade odontológica para a importância do bom planejamento e conduta terapêutica adequados para cada caso

Among the defects of craniofacial development, Hyperdontia represents a relevant number of changes of the tooth development, due to its high prevalence and its potential for functional and aesthetically compromising the affected patients. This paper describes the case of a 5 years-old patient, affected by the development of two dental elements supernumerary in the anterior maxilla. The case was diagnosed from radiographic evaluation associated with clinical aspect of ectopic eruption of the supernumerary elements by palatal face of the upper deciduous incisors, which presented with physiological mobility due to the development of their successors. The treatment chosen for the case was the extraction of the deciduous elements mobility and supernumerary element erupted opting up by removal of the supernumerary element included at a later stage, since this was not associate with any functional or esthetic damage, and also by the fact that the removal of that would generate high morbidity to pediatric patient. This case emphasizes the importance of dental surgeon in monitoring of human craniofacial development, since this may be accompanied by significant disorders. Moreover, this case alerts the dental community to the importance of good planning and adequate therapeutic approach for each case

Clinical and histopathological analysis of oral squamous cell carcinoma in young people: a descriptive study in Brazilians.

We retrospectively analysed the clinical and histological characteristics of oral squamous cell carcinoma (SCC) in a sample of Brazilian patients 45 years of age or less. Files from a single oral histopathological service were studied during the period 1990 to 2005 and the clinical data collected. The histological sections of the invasive part of each tumour were analysed and classified using the criteria of Bryne et al. A total of 46 patients were selected, 36 (78%) of whom were white; 38 (83%) were male; and the most common site was the floor of the mouth (n=14, 30%) followed by the tongue (n=13, 28%). Most selected patients used tobacco and alcohol, and 43 were diagnosed as having clinical stages III and IV disease. Nine of the tumours (20%) were well differentiated, 23 were moderately differentiated, and the rest (n=14) were poorly differentiated. The characteristics of this group suggest that oral SCC in young patients does not behave differently from the oral SCC found in the overall population.

Correlation between koilocytes and human papillomavirus detection by PCR in oral and oropharynx squamous cell carcinoma biopsies

The purpose of this study was to compare the histopathological analysis with polymerase chain reaction (PCR) methods to predict the presence of human papillomavirus (HPV) infection in oral squamous cell carcinoma biopsies. Eighty-three paraffin-embedded tissue specimens from patients with oropharynx and mouth floor squamous cell carcinoma were submitted to histopathological analysis under light microscopy, specifically for the determination of the presence of koilocytes. Subsequently, DNA was purified from the same paraffin-embedded specimens and submitted to PCR. Fisher's exact test showed no statistically significant correlation between the two methods. The results suggest that the presence of koilocytes is unreliable for the detection of HPV presence in oral and oropharynx squamous cell carcinoma.

Effects of resin luting agents and 1 percent NaOCl on the marginal fit of indirect composite restorations in primary teeth

OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1 percent sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1 percent NaOCl irrigation+EnForce); G2 (EnForce); G3 (1 percent NaOCl irrigation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100 percent relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (α=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1 percent NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico / Idiopathic thrombocytopenic purpura: importance of the dentist in this diagnosis

Esse trabalho descreve um caso de púrpura trombocitopênica idiopática (PTI) diagnosticado durante exame odontológico de rotina. A PTI é uma desordem caracterizada pela destruição anormal das plaquetas circulantes e geralmente apresenta manifestações bucais. Dessa forma, destacamos a importância de o cirurgião-dentista estar apto a reconhecer os sinais e sintomas da PTI, principalmente mudanças bucais que não têm origem dental, possibilitando tratamento imediato. Esta patologia quando não tratada, pode ser irreversível e fatal.