Diabetes na odontologia: manifestações bucais e condutas para atendimento / Diabetes in dentistry: Oral manifestations and conducts for care

Introdução: O Diabetes Mellitus inclui um grupo de doenças metabólicas caracterizadas por hiperglicemia, resultantes de defeitos na secreção da insulina e/ou em sua ação. É uma patologia de importância para a saúde sistêmica e geral dos portadores, devendo ser especialmente considerada no planejamento e tratamento odontológicos. Objetivos: Este estudo teve por objetivo abordar o DM, respaldando etiologia, patogenia e aspectos clínicos, bem como suas complicações, que possam ocorrer durante o tratamento odontológico. Métodos: Este estudo caracterizou-se por uma busca bibliográfica nas bases de dados eletrônicos PubMED/Medline, Lilacs, Scielo e Scopus, limitando-se ao período de 2005 a 2020. Os descritores utilizados foram: diabetes mellitus, atenção odontológica e manifestações bucais. Resultados obtidos: O DM consiste em um grupo de doenças metabólicas caracterizadas pelo aumento excessivo da glicemia sérica. Existem três tipos de diabetes: tipo 1 (aproximadamente 5% dos casos), tipo 2 (90-95% dos casos) e gestacional. O paciente diabético pode apresentar, com maior frequência, algumas manifestações bucais como as doenças periodontais, halitose, disfunções salivares, infecções fúngicas e infecções bacterianas. Além disso, durante atendimento odontológico, pode ser necessário realizar algumas adequações nos protocolos clínicos utilizados nesses pacientes. Conclusão: É importante incentivar os pacientes com DM a visitarem regularmente o cirurgião dentista (CD), para que sejam orientados e recebam instruções sobre saúde bucal e sua relação com doenças sistêmicas. Em alguns casos, o encaminhamento para atendimento médico pode ser necessário antes do início do tratamento, exceto em casos de urgência odontológica.

Introduction: Diabetes Mellitus includes a group of metabolic diseases characterized by hyperglycemia, resulting from defects in insulin secretion and/or its action. It is a pathology of importance for the systemic and general health of patients, and it should be especially considered in dental planning and treatment. Objectives: This study aimed to address DM, supporting etiology, pathogenesis, and clinical aspects, as well as its complications, which may occur during dental treatment. Methods: This study was characterized by a bibliographic search in the electronic databases PubMED / Medline, Lilacs, Scielo and Scopus, limited to the period from 2005 to 2020. The descriptors used were diabetes mellitus, dental care, and oral manifestations. Results obtained: DM consists of a group of metabolic diseases characterized by an excessive increase in serum glucose. There are three types of diabetes: type 1 (approximately 5% of cases), type 2 (90-95% of cases) and gestational. The diabetic patient may more frequently present some oral manifestations such as periodontal diseases, halitosis, salivary dysfunctions, fungal infections, and bacterial infections. In addition, during dental care it may be necessary to make some adjustments to the clinical protocols used in these patients. Conclusion: It is important to encourage patients with DM to regularly visit the dental surgeon (DS), so that they are guided and receive instructions on oral health and its relationship with systemic diseases. In some cases, referral to medical care may be necessary before treatment begins, except in cases of dental urgency.

Toxina botulínica como opção no tratamento da disfunção temporomandibular / Botulinic toxin as an option in treating Temporomandibular Dysfunction

Uma grande parcela de odontólogos está optando pelo uso de toxina botulínica (TxB) em seus pacientes. Sua aplicação é diversa, podendo tanto ser utilizada para fins estéticos, como terapêuticos. Em estudos preliminares, a TxB tem sido usada com sucesso para tratar várias síndromes de dor, incluindo o disfunção temporomandibular (DTM). O objetivo deste trabalho é discutir a aplicação da toxina botulínica como forma de tratamento das disfunções temporomandibulares, além de revisar alguns estudos e técnicas de aplicação. Trata-se de uma revisão de literatura, realizada no mês de janeiro de 2019, referente aos últimos cinco anos, por meio das bases de dados online PubMED/Medline, Lilacs e Scielo. Os descritores utilizados foram: treatment and Botulinum toxins and disorders and temporomandibular joint como mecanismo de busca, sendo selecionados apenas os disponíveis em sua versão completa (Full Text). Um total de 136 artigos foram levantados, sendo 118 no Pubmed, com 58 selecionados disponíveis em sua versão completa (Full Text), após uma cautelosa seleção sobre o assunto. No Lilacs, foram encontrados 12 artigos, dos quais apenas 6 condiziam com assunto, e no Scielo, foram encontrados 6 artigos, nos quais 5 eram duplicados e 1 não condizia com o assunto. Mesmo existindo outras soluções tradicionais disponíveis, a toxina botulíca pode ser um tratamento viável, seguro e eficaz para muitas disfunções da musculatura facial e oral, principalmente em casos refratários ao tratamento convencional.

The use of botulinum toxin by dentists, in their patients, increased in recent times.It's a diverse treatment, it can be used both in esthetic or therapeutic purpose. In previous studies, botulinum toxin has been used successfully in the treatment of several pathological pains, including temporomandibular joint (TMJ) dysfunction. To discuss botulinum toxin use as a treatment for temporomandibular joint (TMJ) dysfunction, also review some studies and application techniques. This paper is a review of a recent articlein temporomandibular joint (TMJ) dysfunction treatment using botulinum toxin. The bibliographic research was done in January, 2019, in the last five years, through the online data bases PubMED / Medline, Lilacs and Scielo. The key words used in the search were "treatment" and "Botulinum toxin" and "dysfunction" and "temporomandibular ". Overall of 136 items were found. In the PubMED/Medline was found 118 papers and of those were selected only the available in Full text. After a careful selection on the papers about the subject, and limiting the search between the period from 1976 to 2019, 58 papers were chosen. In the other hand, on Lilacs, 12 papers were found, of which only 6 corresponded to the subject, and on the Scielo were found 6 papers in which 5 were duplicated and 1 did not agree to the subject. Even if other traditional solutions exists, the research shows that botulinum toxin is a viable, safe and effective treatment for many facial and oral musculature dysfunctions, mainly in refractory cases to conventional treatment.

Epidemiological profile of young patients with squamous cell carcinoma in northeast Brazil.

AIM: The aim of the present study was to delineate the epidemiological profile of young patients with squamous cell carcinoma (SCC) treated at a healthcare service in northeastern Brazil. METHODS: A cross-sectional study was performed involving the quantitative analysis of 51 medical records from patients diagnosed with SCC between 1998 and 2013. All patients aged ≤50 years were included in the study. Statistical analysis involved Pearson's χ2 -test, Fisher's exact test, and the Mann-Whitney U-test, with the level of significance set at 5% (P < .05). RESULTS: The mean age was 46 ± 7.94 years, and males accounted for 80.4% of the sample. The tongue was the most affected site (37.3%). Most tumors were classified as stage III (26.3%) or IV (42.1%). Surgery associated with chemotherapy was the most common therapeutic approach (39.3%). Female patients had a lower mean age (P = .013) and less advanced clinical staging (P = .022). Smoking was more associated with male sex (P = .043). CONCLUSION: SCC in young patients is more common in males aged 46 ± 7.94 years, with the tongue being the most affected anatomic site. Important differences were found in clinical-epidemiological features between young men and women.

[Pain, anxiety and quality of life related to the oral health of patients treated in a dental emergency clinic]. / Dor, ansiedade e qualidade de vida relacionada à saúde bucal de pacientes atendidos no serviço de urgência odontológica.

The scope of this study was to assess the association between preoperative pain, anxiety and the impact of the oral condition on the quality of life of patients treated at the Dental Emergency Service at the Federal University of the Jequitinhonha and Mucuri Valleys. A retrospective cross-sectional study was conducted evaluating data from 240 patient charts aged from 18 to 65 years. Pain was measured by the Heft-Parker Visual Analog Scale; dental anxiety by Corah's Dental Anxiety Scale; and oral health-related quality of life by the Oral Health Impact Profile (OHIP-14). Associations were analyzed using Pearson's Chi-square test (p < 0.05). A statistically significant association was observed between pain and poorer quality of life, with impacts on psychological discomfort (p < 0.001), physical incapacity (p < 0.001) and the psychological (p < 0.001) and social (p < 0.001) domains. Anxiety influenced poorer quality of life, with impacts on the psychological discomfort (p = 0.009), physical disability (p = 0.016), psychological disability (p = 0.011) and social disadvantage (p = 0.028) domains. This study is relevant for the planning of programs and actions aimed at the oral health of patients treated in dental emergency services, prioritizing those with the greatest psychosocial impact arising from oral problems.

O objetivo deste estudo foi avaliar associação entre dor pré-operatória, ansiedade e impacto da condição bucal na qualidade de vida dos pacientes atendidos no serviço de Urgência Odontológica da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Estudo transversal retrospectivo foi conduzido avaliando dados clínicos de 240 prontuários de pacientes com idades entre 18 e 65 anos. A dor foi mensurada pela Heft-Parker Visual Analogue Scale; ansiedade, pela Corah's Detal Anxiety Scale e qualidade de vida, pelo Oral Health Impact Profile (OHIP-14). Associações foram analisadas pelo Teste qui-quadrado de Pearson (p < 0,05). Foi observada associação estatisticamente significante entre dor e pior qualidade de vida, com impacto nos domínios desconforto psicológico (p < 0,001), incapacidade física (p < 0,001), psicológica (p < 0,001) e social (p < 0,001). Ansiedade influenciou na pior qualidade de vida, com impacto nos domínios desconforto psicológico (p = 0,009), incapacidade fisica (p = 0,016), psicológica (p = 0,011) e desvantagem social (p = 0,028). Esse estudo é relevante para o planejamento de ações voltadas para a saúde bucal dos pacientes atendidos nos serviços de urgência odontológica, priorizando aqueles com maiores impactos psicossociais decorrentes dos problemas bucais.

Dor, ansiedade e qualidade de vida relacionada à saúde bucal de pacientes atendidos no serviço de urgência odontológica / Pain, anxiety and quality of life related to the oral health of patients treated in a dental emergency clinic

Resumo O objetivo deste estudo foi avaliar associação entre dor pré-operatória, ansiedade e impacto da condição bucal na qualidade de vida dos pacientes atendidos no serviço de Urgência Odontológica da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Estudo transversal retrospectivo foi conduzido avaliando dados clínicos de 240 prontuários de pacientes com idades entre 18 e 65 anos. A dor foi mensurada pela Heft-Parker Visual Analogue Scale; ansiedade, pela Corah's Detal Anxiety Scale e qualidade de vida, pelo Oral Health Impact Profile (OHIP-14). Associações foram analisadas pelo Teste qui-quadrado de Pearson (p < 0,05). Foi observada associação estatisticamente significante entre dor e pior qualidade de vida, com impacto nos domínios desconforto psicológico (p < 0,001), incapacidade física (p < 0,001), psicológica (p < 0,001) e social (p < 0,001). Ansiedade influenciou na pior qualidade de vida, com impacto nos domínios desconforto psicológico (p = 0,009), incapacidade fisica (p = 0,016), psicológica (p = 0,011) e desvantagem social (p = 0,028). Esse estudo é relevante para o planejamento de ações voltadas para a saúde bucal dos pacientes atendidos nos serviços de urgência odontológica, priorizando aqueles com maiores impactos psicossociais decorrentes dos problemas bucais.

Abstract The scope of this study was to assess the association between preoperative pain, anxiety and the impact of the oral condition on the quality of life of patients treated at the Dental Emergency Service at the Federal University of the Jequitinhonha and Mucuri Valleys. A retrospective cross-sectional study was conducted evaluating data from 240 patient charts aged from 18 to 65 years. Pain was measured by the Heft-Parker Visual Analog Scale; dental anxiety by Corah's Dental Anxiety Scale; and oral health-related quality of life by the Oral Health Impact Profile (OHIP-14). Associations were analyzed using Pearson's Chi-square test (p < 0.05). A statistically significant association was observed between pain and poorer quality of life, with impacts on psychological discomfort (p < 0.001), physical incapacity (p < 0.001) and the psychological (p < 0.001) and social (p < 0.001) domains. Anxiety influenced poorer quality of life, with impacts on the psychological discomfort (p = 0.009), physical disability (p = 0.016), psychological disability (p = 0.011) and social disadvantage (p = 0.028) domains. This study is relevant for the planning of programs and actions aimed at the oral health of patients treated in dental emergency services, prioritizing those with the greatest psychosocial impact arising from oral problems.

Prospective evaluation of quality of life in patients with head and neck cancer.

OBJECTIVES: This study aimed to evaluate, prospectively, the quality of life of patients with head and neck cancer. STUDY DESIGN: A quantitative, longitudinal, and prospective study was conducted. The survey instrument was the University of Washington quality of life questionnaire. The sample consisted of 47 patients. For data analysis, paired t test, McNemar test, Student t test, and 1-way analysis of variance tests were used. The significance level was 5% (P < .05). RESULTS: Mood (68.89 ± 35.41) and anxiety (70.22 ± 32.99) domains were the most affected at the time of diagnosis. Chewing (71.11 ± 39.15) and speech (76.22 ± 33.72) domains were the most affected in the revaluation of the questionnaire, after 3 months. In the temporal assessment of the domains at diagnosis and after 3 months, it was observed that domains that improved quality of life were pain (P = .013) and mood (P = .039). Swallowing (P = .017), chewing (P = .024), speech (P = .048), and saliva (P = .004) domains produced a worse quality of life. CONCLUSIONS: The parameters that influence quality of life differ when the the University of Washington quality of life questionnaire is applied at the time of diagnosis and 3 months after diagnosis.

Oral mucosal conditions in preschool children of low socioeconomic status: prevalence and determinant factors.

The aim of the present study was to determine the prevalence of oral mucosal conditions and associated factors among 541 preschoolers of low socioeconomic status. A cross-sectional study was carried out. Sociodemographic data and information on harmful oral habits were gathered with the use of a questionnaire. A clinical exam was performed for the determination of oral mucosal conditions, dental caries and level of oral hygiene. Data analysis involved statistical analysis, the Kruskal-Wallis test, Mann-Whitney test, chi-square test, Fisher's exact test and multivariate regression (p < 0.05, 95 % CI). The prevalence of oral mucosal conditions was 40.7 %. The most prevalent oral mucosal conditions were coated tongue (23.4 %), melanotic macules (14.4 %), oral ulcers (11.8 %), Fordyce's spots (8.1 %), angular cheilitis (3.0 %), geographic tongue (2.8 %), linea alba (1.5 %) and fistula (1.3 %). Children between 3 and 5 years of age had a greater chance of exhibiting coated tongue (OR, 2.55; 95 % CI, 1.6-4.1), melanotic macules (OR, 4.07; 95 % CI, 2.3-7.2) and Fordyce's spots (OR, 12.70; 95 % CI, 7.2-28.6). The female gender had a greater chance of exhibiting melanotic macules (OR, 2.23; 95 % CI, 1.3-1.8). Coated tongue was more prevalent among children from low-income families (OR, 2.35; 95 % CI, 1.3-4.3) and those with inadequate oral hygiene (OR, 4.65; 95 % CI, 2.9-7.4). Caries constituted a predictive factor for oral ulcers (OR, 2.15; 95 % CI, 1.2-3.9) and fistula (OR, 12.00; 95 % CI, 1.4-11.3). Bruxism (teeth clenching/grinding) was a predictive factor for angular cheilitis (OR, 5.55; 95 % CI, 1.9-16.3). The determinant factors for oral mucosal conditions were the female gender, age between 3 and 5 years, inadequate oral hygiene, low household income, residence in rural areas and presence of dental caries and bruxism.

Basosquamous carcinoma: histopathological features.

Basosquamous carcinoma (BSC) is a rare aggressive epithelial neoplasm with features of both basal cell carcinoma and squamous cell carcinoma, with a tendency toward local recurrence and a propensity for lymph node and distant metastases. The aim of the present study was to report the case of a 63-year-old Caucasian male with BSC in the auricular region.

Does intellectual disability affect the development of dental caries in patients with cerebral palsy?

The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of these, 76 individuals had been diagnosed with spastic cerebral palsy and 89 had no neurological impairment. The subjects were matched based on age and gender and selected randomly by lottery. All patients were examined to determine the number of dental cavities, and tested for their intellectual functioning (Raven Test) and motor abilities. The study showed that children with CP who presented with intellectual disabilities had a larger number of dental cavities than children with CP without intellectual disabilities. Considering intellectual functioning and motor impairment in the multivariate logistic regression, only intellectual functioning was found to have a significant effect on the development of dental cavities. These results suggest that intellectual disability can be considered a contributing factor for the development of dental caries in patients with cerebral palsy.

Effect of topical application of different substances on fibroplasia in cutaneous surgical wounds.

BACKGROUND: Fibroblasts on the edges of a surgical wound are induced to synthesize collagen during the healing process which is known as fibroplasia. OBJECTIVE: The aim of this study was to determine the effect of the application of different substances on fibroplasia of cutaneous surgical wounds on rats. MATERIALS AND METHODS: Forty-eight Wistar rats were divided into three groups. A surgical wound 1 cm in diameter and 1 mm in depth was created on the dorsum of each animal. The surgical wounds were submitted to the topical application of an alcoholic extract of 30% propolis, 70% alcohol, or 0.001% dexamethasone in a cream base every 12 hours. The animals were sacrificed three, seven, 14, and 28 days postoperatively. The specimens were histologically processed and stained with Masson's trichome. The assessment of fibroplasia was performed using a scoring system: (1) 5 to 25% collagen deposition; (2) 26 to 50% collagen deposition; (3) 51 to 75% collagen deposition; and (4) more than 75% collagen deposition. RESULTS: There were statistically significant differences in collagen deposition between the substances at all postoperative evaluation times. CONCLUSION: Propolis and alcohol promoted greater collagen deposition in surgical wounds than dexamethasone.

Effect of propolis on mast cells in wound healing.

Wound healing is divided into three phases: inflammatory, proliferative and remodeling. Mast cells participate in all these phases. The aim of the present study was to determine the effects of propolis on the population of mast cells in oral surgical wounds in comparison to the results obtained with dexamethasone. This study was prospective, in vivo, randomized, semiexperimental, quantitative and comparative animal. A circular surgical wound was made on the dorsum of the tongue of 90 hamsters divided into three experimental groups: topical application of 30% propolis alcoholic extract (Group 1); 0.1% dexamethasone in orabase cream (Group 2); and orabase cream alone (Group 3). Applications were performed every 12 h throughout the experiment. The postoperative times for killing of the animals were 1, 3, 7, 14 and 28 days. The Student's t test for independent samples was employed in the statistical analysis. In the inflammatory phase of healing, propolis caused a greater reduction in the number of mast cells on the edge and in the central region of the surgical wound in comparison to dexamethasone. Moreover, the number of mast cells on day 1 was lower in the central region of the wounds treated with the orabase cream alone in comparison to dexamethasone. In conclusion, the anti-inflammatory action of propolis mediated by mast cells was more effective than dexamethasone in the inflammatory phase of healing.

Dental trauma clinically mimicking single central incisor syndrome / Traumatismo dentário mimetizando clinicamente a síndrome do incisivo central único

PURPOSE: This paper presents a clinical case in which a patient was missing a median central incisor due to trauma but was referred for orthodontic treatment because of suspicions of solitary median maxillary central incisor (SMMCI) syndrome. CASE DESCRIPTION: A 12-year-old female patient visited the clinic with concerns about the appearance of her teeth. An oral examination revealed the presence of a single central incisor that was located on the midline and was adjacent to the maxillary lateral incisors. The patient reported two episodes of dental avulsion (of teeth 11 and 21) that had occurred approximately four years earlier. Tooth 11 was replanted; however, it was subsequently extracted due to pain. A panoramic radiograph and cephalometric analysis revealed a history of unsuccessful root canal treatment on tooth 21, a straight profile and symmetrical facial features. Tooth 21 was extracted, followed by the traction of the maxillary teeth in the mesial direction and the esthetic transformation of the lateral incisors into central incisors and the canines into lateral incisors. CONCLUSION: Dental trauma followed by tooth loss may mimic solitary median maxillary central incisor syndrome.

OBJETIVO: Apresentar um caso clínico de ausência de um incisivo central perdido por traumatismo e encaminhado ao ortodontista com suspeita de apresentar síndrome do incisivo central único (SMMCI). DESCRIÇÃO DO CASO: Paciente gênero feminino, 12 anos com queixa da aparência de seus dentes. Ao exame intrabucal observou-se a presença de um incisivo central único localizado na linha média sem espaçamentos em relação aos incisivos laterais superiores. A paciente relatou dois episódios de avulsão dos dentes 11 e 21, cerca de quatro anos antes. No entanto, devido a sintomas de dor após reimplante, o dente 11 foi extraído. A radiografia panorâmica e análise cefalométrica revelou a presença de tratamento insatisfatório do canal radicular do dente 21, um perfil reto e padrão de equilíbrio facial. Extração do dente 21 foi realizada, com tração posterior dos dentes superiores na direção mesial, seguido pela transformação estética dos incisivos laterais em incisivos centrais e dos caninos em incisivos laterais. CONCLUSÃO: O traumatismo seguido de perda dentária pode mimetizar um quadro de síndrome do incisivo central único.

Identification of candida spp. by phenotypic tests and PCR

The correct identification of Candida species is of great importance, as it presents prognostic and therapeutical significance, allowing an early and appropriate antifungical therapy. The purpose of this study was to identify isolates of Candida spp. from oral mucosa of 38 patients with oral candidosis evaluated in 2004 by phenotypic methods and PCR, discriminating C. albicans from the other Candida species. The tests used for phenotypic analysis were germ-tube and chlamydoconidia production, culture in CHROMAgarTM Candida, carbohydrate assimilation test, growth at 45ºC and culture in Tween 80 agar. Genotypic confirmation was performed by PCR. Phenotypic tests showed that 63.2 percent strains formed germ-tubes, 73.7 percent produced chlamydoconidia, and 63.2 percent showed green colonies in chromogenic medium, presumptively indicating C. albicans or C. dubliniensis. The carbohydrate assimilation test confirmed these results. A total of 21 percent strains were identified as C. krusei and 13.2 percent were indicative of C. tropicalis. Of these later strains, three produced chlamydoconidia. The association of other phenotypic tests with culture in Tween 80 agar identified 95.8 percent of strains as C. albicans and 4.2 percent as C. dubliniensis. All 24 strains indicative of C. albicans and C. dubliniensis were confirmed by PCR as C. albicans.

Identification of Candida spp. by phenotypic tests and PCR.

The correct identification of Candida species is of great importance, as it presents prognostic and therapeutical significance, allowing an early and appropriate antifungical therapy. The purpose of this study was to identify isolates of Candida spp. from oral mucosa of 38 patients with oral candidosis evaluated in 2004 by phenotypic methods and PCR, discriminating C. albicans from the other Candida species. The tests used for phenotypic analysis were germ-tube and chlamydoconidia production, culture in CHROMAgar™ Candida, carbohydrate assimilation test, growth at 45ºC and culture in Tween 80 agar. Genotypic confirmation was performed by PCR. Phenotypic tests showed that 63.2% strains formed germ-tubes, 73.7% produced chlamydoconidia, and 63.2% showed green colonies in chromogenic medium, presumptively indicating C. albicans or C. dubliniensis. The carbohydrate assimilation test confirmed these results. A total of 21% strains were identified as C. krusei and 13.2% were indicative of C. tropicalis. Of these later strains, three produced chlamydoconidia. The association of other phenotypic tests with culture in Tween 80 agar identified 95.8% of strains as C. albicans and 4.2% as C. dubliniensis. All 24 strains indicative of C. albicans and C. dubliniensis were confirmed by PCR as C. albicans.

Study of intussusceptive angiogenesis in inflammatory regional lymph nodes by scanning electron microscopy.

The aim of the present study was to verify the occurrence of intussusceptive angiogenesis in blood vessels from submandibular lymph nodes responsible for lymphatic drainage of the tongue. A surgical wound inflicted on the ventral tongue of male Wistar rats and submandibular regional lymph nodes were evaluated at different postoperative periods. Scanning electron microscopy (SEM) was used to observe 123 lymph nodes at times 2, 3, 7, 10, 14, and 21 postoperative days. During the analysis of the vascular models with SEM, intussusceptive angiogenesis was observed in all groups evaluated. This was more extensive on the second and third postoperative days (83.33% and 80%, respectively), representing in these groups the expansion of the vascular chain of lymph nodes. At 21 postoperative days, intussusceptive angiogenesis (42.85%) was suggestive of vascular remodeling.

Oral and cutaneous melanoma: similarities and differences.

UNLABELLED: Melanomas are malignant lesions stemming from the disorganized proliferation of melanocytes. This condition is more common on skin, but may also be detected in mucosa, such as in the oral cavity. The aim of the present study was to report similarities and differences between oral and cutaneous melanoma. KEYWORDS: Melanoma; Skin; Mouth; Diagnosis.

Angioarchitecture of the ventral surface of the tongue from Wistar rats.

The goal of this study was to describe the angioarchitecture of the ventral surface of the tongue from Wistar rats using a vascular corrosion casting technique associated with scanning electron microscopy (SEM). Six Wistar rats were used for the vascular casting method with Mercox resin. Following the resin polymerization, the tongue of each animal was dissected and corroded in a 5% sodium hydroxide solution. Once the corrosion and drying of the specimens were completed, the specimens were mounted on aluminum stubs, coated with carbon and gold and analyzed under SEM. The results showed that the ventral surface of the tongue presents simple, even and abundant vasculature constituted by a vascular plexus consisting of a superficial vascular network and by the ranine veins. The superficial vascular network, made up of the ascending and descending branches, presents as a loose network, with little morphological variation between the capillary loops.

Extensive myiasis infestation over a squamous cell carcinoma in the face. Case report.

Human myiasis is a parasitosis found in tropical and underdeveloped countries. It usually affects the elderly, unhealthy and mentally disabled individuals. It is caused by dipterous that lay their eggs in necrotic or infected tissues, although areas of the body that are apparently healthy can also be affected. Frequently the fly deposits several eggs on the peripheral parts of scratches and wounds. The treatment of myiasis involves mechanical removal of the larvae with hemostatic pincers. Larvae rupture must be avoided. Application of topical ether or similar volatile substance is useful. Preventive approach measures, including basic health care, hygiene, access to primary health service, and safe water and drainage, are fundamental to prevent human myiasis. The authors present a case report of myiasis infestation over an extensive head and neck squamous cell carcinoma from a 72-year-old patient living in a rural area. Approximately 200 larvae were removed and the patient was taken to the hospital's head and neck surgery service.

Extensive myiasis infestation over a squamous cell carcinoma in the face. Case report

No disponible

Human myiasis is a parasitosis found in tropical and underdeveloped countries. It usually affects the elderly, unhealthy and mentally disabled individuals. It is caused by dipterous that lay their eggs in necrotic or infected tissues, although areas of the body that are apparently healthy can also be affected. Frequently the fly deposits several eggs on the peripheral parts of scratches and wounds. The treatment of myiasis involves mechanical removal of the larvae with hemostatic pincers. Larvae rupture must be avoided. Application of topical ether or similar volatile substance is useful. Preventive approach measures, including basic health care, hygiene, access to primary health service, and safe water and drainage, are fundamental to prevent human myiasis. The authors present a case report of myiasis infestation over an extensive head and neck squamous cell carcinoma from a 72-year-old patient living in a rural area. Approximately 200 larvae were removed and the patient was taken to the hospital’s head and neck surgery service

Síndrome de Sturge-Weber / Sturge-Weber syndrome

A síndrome de Sturge-Weber é uma doença neurocutânea congênita, não hereditária, caracterizada porangiomatoses que envolvem face e cérebro. A alteração facial, conhecida como nevo flâmeo, é geralmenteunilateral e acompanha o trajeto do nervo trigêmeo, preferencialmente o ramo oftálmico, embora possaafetar também os outros ramos desse nervo. Quando os ramos maxilar e mandibular são afetados,ocorrem hipervascularização da mucosa bucal e hiperplasias gengivais. As malformações vasculares queafetam as leptomeninges aparecem como calcificações em exames imaginológicos. O paciente apresentaconvulsões geralmente contralaterais à malformação cerebral e ao nevo flâmeo. O tratamento implicao uso de anticonvulsivantes, que também podem provocar hiperplasia gengival. Ocasionalmente, realizam-se cirurgias cerebrais em idade precoce para controlar epilepsias resistentes aos medicamentos; já alaserterapia pode ser empregada para clarear a lesão facial, embora se deva enfatizar que há casos compobre resposta e alta taxa de recidiva. A necessidade de higiene bucal rigorosa deve ser enfatizada, e ashiperplasias gengivais podem ser removidas cirurgicamente, com os devidos cuidados para que se evitemquadros hemorrágicos.

Sturge-Weber Syndrome (SWS) is a congenital neurocutaneous disease with no hereditary basis, characterizedby facial and cerebral angiomatosis. The facial alteration, named nevus flammeus, is often unilateral,involving the sensory trigeminal nerve branches, especially the ophtalmic one. When maxillary and mandibularbranches are affected, hypervascularization of the oral mucosa and gum hyperplasia are present.Leptomeningeous venous malformations as well as calcified areas are observed on radiologic images.Usually, patients have seizures contralateral to the cerebral malformation and nevus flammeus. Treatmentimplies antiepileptic drugs, which can also induce gum hyperplasia. Brain surgery can be conducted inearly ages to control seizures, and lasertherapy could improve the facial lesion, although with poor outcomesin some cases. The necessity of rigorous oral hygiene should be emphasized and gingival hyperplasiasurgical excision is not contraindicated, although it requires care to avoid hemorrhage.