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.

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.

Antimicrobial activity of limonene: integrative review / Actividad antimicrobiana del limoneno: revisión integrativa

Limonene is the main component of citrus essential oils, and can reach a concentration of up to 96%. Popularly known for its potential therapeutic effects on the body, among these we point out its broad antimicrobial activity against various types of pathogens. Therefore, the purpose of this study was to address the antimicrobial and antifungal properties of limonene compared to microorganisms of interest in dentistry, based on a bibliometric study and literature review. The following databases were analyzed: PubMed, Google Scholar, SciELO and Science Direct, from which ten articles published between 2011-2021 were selected. Most of results indicate a satisfactory antimicrobial potential, besides providing important data and perspectives regarding the indication and clinical use, in addition to innovative therapeutic modalities for diseases that affect the oral cavity, such as tooth decay, periodontal disease and candidosis.

El limoneno es el componente principal de los aceites esenciales cítricos, y puede alcanzar una concentración de hasta el 96%. Popularmente conocido por sus potenciales efectos terapéuticos en el organismo, entre ellos se destacan su amplia actividad antimicrobiana frente a diversos tipos de patógenos. Por lo tanto, el objetivo de este estudio fue abordar las propiedades antimicrobianas y antifúngicas del limoneno en comparación con microorganismos de interés en la odontología, a partir de un estudio bibliométrico y una revisión bibliográfica. Se analizaron las siguientes bases de datos: PubMed, Google Scholar, SciELO y Science Direct, de las cuales se seleccionaron diez artículos publicados entre 2011-2021. La mayoría de los resultados indican un potencial antimicrobiano satisfactorio, además de proporcionar datos y perspectivas importantes con respecto a la indicación y el uso clínico, así como modalidades terapéuticas innovadoras para enfermedades que afectan la cavidad oral, como caries, enfermedad periodontal y candidosis.

Ethnobotanical knowledge of herbalists about medicinal plants from the semiarid region in northeastern Brazil / Conocimiento etnobotánico de herbolarios sobre plantas medicinales de la región semiárida del noreste de Brasil

Medicinal plants have been used since ancient times to treat illnesses. This study aimed to identify through questionnaire the medicinal plants most frequently sold on public and street markets in some municipalities of Paraíba state, northeastern Brazil, and the knowledge of herbalists about their therapeutic indications and forms of use. The sample consisted of 28 herbalists. Fifteen plants with a dental indication were identified, including barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), gengibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) and quixaba (Sideroxylon obtusfolium), as well as 21 plants used for the treatment of general diseases, including barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) and erva doce (Pimpinella anisum). Bottled preparations ("garrafadas")and teas were the most frequently indicated forms of use. The results suggest that herbalists have a vast traditional knowledge of the therapeutic potential of commercialized plants.

Las plantas medicinales se han utilizado desde la antigüedad para tratar enfermedades. Este estudio tuvo como objetivo identificar a través de cuestionario las plantas medicinales más vendidas en mercados públicos y callejeros en algunos municipios del estado de Paraíba, noreste de Brasil, y el conocimiento de los herbolarios sobre sus indicaciones terapéuticas y formas de uso. La muestra estuvo formada por 28 herbolarios. Se identificaron quince plantas con indicación dental, entre las que se encuentran barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), jenjibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) y quixaba (Sideroxylon obtusfolium), así como 21 plantas utilizadas para el tratamiento de enfermedades generales, incluidas barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) y erva doce (Pimpinella anisum). Las preparaciones embotelladas ("garrafadas") y los tés fueron las formas de uso más frecuentemente indicadas. Los resultados sugieren que los herbolarios tienen un vasto conocimiento tradicional del potencial terapéutico de las plantas comercializadas.

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.

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.

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.

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.

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.

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.

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. .

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. .

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.

Analgesia durante o tratamento ortodôntico com o uso do laser de baixa intensidade: revisão sistemática / Analgesia during orthodontic treatment with low intensity laser: systematic review

JUSTIFICATIVA E OBJETIVOS: A dor é um sintoma clínico característico em estágios iniciais do tratamento ortodôntico. O objetivo deste estudo foi rever na literatura o uso da terapia a laser de baixa intensidade na redução da dor durante o tratamento ortodôntico. CONTEÚDO: Uma busca de títulos, resumos e artigos foram realizadas nas bases de dados Pubmed/Medline, Cochrane Library, LILACS e Scielo. Três pesquisadores realizaram de forma independente uma busca utilizando critérios de inclusão e exclusão definidos. Foram incluídos oito ensaios clínicos, sendo que seis deles verificaram redução significativa da dor após uso do laser terapêutico. CONCLUSÃO: Existe evidência científica de que o uso do laser de baixa intensidade diminui a sintomatologia dolorosa após colocação de elásticos ortodônticos e após realização de ajustes ortodônticos durante a movimentação dentária. O seu uso por profissionais da área é uma alternativa viável por apresentar menos efeitos colaterais em relação a analgésicos anti-inflamatórios, sendo bem indicado a pacientes alérgicos, crianças e pacientes com comprometimento sistêmico. No entanto, há a necessidade de investigações científicas adicionais que utilizem protocolos bem definidos.

BACKGROUND AND OBJECTIVES: Pain is a typical symptom during early orthodontic treatment. This study aimed at reviewing the literature on the use of low intensity laser to relieve pain during orthodontic treatment. CONTENTS: Titles, summaries and articles were searched in the following databases: Pubmed/Medline, Cochrane Library, LILACS and Scielo. Three researchers have independently searched using defined inclusion and exclusion criteria. Eight clinical trials were included and six have observed significant pain relief after therapeutic laser. CONCLUSION: There are scientific evidences that low intensity laser decreases pain symptoms during dental movements after the placement of orthodontic elastics and after orthodontic adjustments. Its use by dentists is a feasible alternative for inducing less adverse effects as compared to anti-inflammatory analgesics, being indicated for allergic patients, children and patients with systemic impairment. However, there is the need for further scientific investigations using well-defined protocols.

Correlação dos níveis salivares de Streptococcus mutans com as condições de higiene bucal em escolares de 6 a 12 anos / Correlation of salivary levels of Streptococcus mutans with the conditionsof oral hygiene in schoolchildren between the ages of 6 and 12

Objetive: To evaluate the microbiological salivary levels of Streptococcus mutans by correlating them with conditions of oral hygiene by measuring rates of Oral Simplified Hygiene and the plaque index in schoolchildren between 6 and 12 years of age, enrolled in a State school in the city of Campina Grande, Paraíba. Methods: The sample consisted of 25 students of both genders. An observational study was carried out using comparative, statistical and descriptive procedures, by direct observation through clinical and microbiological analysis. We first measured the simplified oral hygiene index and the plaque index and immediately afterwards the saliva was collected from the schoolchildren in order to perform a count of the colonies of Streptococcus mutans. Results: There was a normal oral hygiene and the mean simplified oral hygiene index equal to 1.7 is in line with the average of 1.6 for the plaque index. A quantitative analysis of the number of colony forming units of Streptococcus mutans showed a variation of between 0.1 x104 CFU/ml and 7.7 x 104 CFU/ml. These data correlated with the index card shows a weak correlation in wich only 11.7% of the variability of the plaque indexis explained by the amount of Streptococcus mutans (CFU/ml x 104)Conclusion: It was shown, therefore, that the Plaque Index present in these schoolchildren, is not related to the amount of salivary microorganisms of thetype Streptococcus mutans (CFU/ml x104).

Objetivo: Avaliar os níveis salivares de Streptococcus mutans correlacionando-os com as condições de higiene bucal através da mensuração dos Índices de Higiene Oral Simplificado e Índice de Placa Bacteriana em escolares de 6 a 12 anos de idade matriculados em uma escola Estadual do município de Campina Grande, Paraíba. Métodos: A amostra foi constituída de 25 escolares de ambos os sexos. Realizou-se um estudo observacional com procedimento comparativo, estatístico e descritivo, através da observação direta por meio do exame clínico e análise microbiológica. Primeiramente foi mensurado o Índice de Higiene Oral Simplificado e o Índice de Placa Bacteriana e logo após foi coletada a saliva dos escolares para contagem das colônias de Streptococcus mutans. Resultados: Observou-se uma higiene bucal regular sendo a média de Índice de Higiene Oral Simplificado igual a 1,7 estando de acordo com a média do Índice de Placa Bacteriana que foi de 1,6. A análise quantitativa do número de unidades formadoras de colônia de Streptococcus mutans revelou uma variação de 0,1x104 UFC/ml a 7,7 x 104 UFC/ml. Esses dados correlacionados com o Ìndice de Placa demonstram uma correlação fraca na qual apenas 11,7% da variabilidade do ìndice de Placa Bacteriana é explicada pela quantidade de Streptococcus mutans (UFC/ml x 104). Conclusão: Com isso, foi demonstrado que o Índice de Placa presente nos escolares não está associado à quantidade de micro-organismos salivares do tipo Streptococcus mutans (UFC/ml x104).

Análise da relação entre a ocorrência da halitose e a presença de saburra lingual / Analysis of the relationship between halitosis and white tongue

OBJETIVO: Avaliar a relação etiológica entre a halitose e a presença de saburra lingual. MÉTODO: Os métodos utilizados foram entrevistas, com preenchimento de uma ficha clínica apropriada; exame clínico (inspeção visual e sondagem periodontal) e aferição do grau de halitose, utilizando o aparelho Breath Alert. O universo desta pesquisa compreendeu os indivíduos atendidos nas clínicas integradas do Departamento de Odontologia da Universidade Estadual da Paraíba, no período destinado à coleta de dados, sendo totalizada uma amostra de 80 pacientes. RESULTADOS: Foi constatado que 66,0 por cento dos pacientes investigados relataram realizar higiene da língua, 32,5 por cento relataram não higienizá-la e 1,5 por cento afirmaram higienizá-la apenas esporadicamente. Verificou-se também que 41,7 por cento dos investigados apresentaram odor leve no hálito e 60,0 por cento daqueles que apresentaram odor moderado exibiram a presença de saburra lingual. No entanto, 52,4 por cento dos pacientes classificados sem odor no hálito também apresentaram tal alteração na língua. A prevalência da halitose na população do estudo foi de apenas 21,3 por cento, na qual 15,0 por cento apresentaram odor leve e 6,3 por cento odor moderado no hálito. CONCLUSÃO: Apesar de a literatura relatar que os fatores que facilitam o acúmulo de biofilme dental na língua, resultando em saburra lingual, influenciam no desenvolvimento e na instalação da halitose, não foi verificado relação significativa, neste experimento, entre a presença de saburra lingual e a ocorrência da halitose.

OBJECTIVE: This study assessed the relationship between halitosis and white tongue. METHODS: The patients were interviewed and a clinical form was filled out. They were also examined by visual inspection and periodontal probing. The degree of halitosis was determined by the Breath Alert device. The universe of this study consisted of individuals who visited the clinics of the State University of Paraiba Dental Department during the study period. The sample consisted of 80 patients. RESULTS: Sixty-six percent of the patients reported cleaning their tongues, 32.5 percent reported never cleaning their tongues and 1.5 percent reported cleaning their tongues periodically. Forty-one point seven percent of the patients with mild halitosis and 60,0 percent of those with moderate halitosis presented white tongue. However, 52.4 percent of the patients without halitosis also presented white tongue. Only 21.3 percent of the sample presented halitosis; 15,0 percent had mild halitosis and 6.3 percent had moderate halitosis. CONCLUSION: According to the literature, the factors that promote the accumulation of dental biofilm on the tongue, resulting in white tongue, also promote the development and establishment of halitosis. However, the present study did not find a significant relationship between white tongue and halitosis.