A primary oral mucosal melanoma of the hard palate with no recurrence: Report of a 10 years follow-up.

BACKGROUND: Primary oral mucosal melanoma (OMM) represents an extremely rare and aggressive tumor that arises from malignant transformation and clonal expansion of melanocytes in the oral cavity. The prognosis of patients affected by OMM is quite unfavorable, with survival rates lower than those described for patients with cutaneous melanoma. CASE REPORT: Here, we report a case of OMM in a 59-year-old Caucasian woman, who was referred for evaluation of a large asymptomatic pigmented lesion on the left side of the hard palate under the removable total denture. Incisional biopsy was performed, and histopathological analysis revealed the proliferation of spindle-shaped and pigmented epithelioid cells, with cellular pleomorphism. These cells were positive for Melan A, S-100, HMB-45, SOX-10, and Ki-67 confirming the diagnosis of OMM. The patient underwent partial maxillectomy and adjuvant radiotherapy. After treatment, she was rehabilitated with a palatal obturator prosthesis and has been in follow-up for 10 years with no evidence of disease. Due to the rarity in the oral cavity and the nonspecific signs and symptoms, the diagnosis of OMM is difficult and often overlooked. CONCLUSION: Therefore, multidisciplinary management from diagnosis, treatment, and rehabilitation is important to increase the expectation of cure.

Melanotic Neuroectodermal Tumor of Infancy: a Clinicopathological Case Report.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm that affects mainly children under 1 year of age. A 4-month-old boy was referred for evaluation of a lesion with 1 month of evolution. Intra-oral examination detected a firm upon palpation submucosal nodular mass, measuring 1.5 cm in diameter, affecting the anterior maxillary alveolar ridge and covered by a slightly blue mucosa with evident telangiectasia. The patient underwent an incisional biopsy and histological and immunohistochemical analyses revealed nests of AE1/AE3 positive epithelioid cells with abundant melanin pigmentation. Other cell types, resembling neuroblasts, were also present and positive for CD56, synaptophysin and enolase. The diagnosis of MNTI was established and the patient was referred for treatment. Conservative surgical resection was performed along with 3 adjacent teeth under general anesthesia. The patient is in follow-up for 1,5 year without recurrence. Conservative surgical management of MNTI may be an alternative to maxillectomy, contributing to the patient´s quality of life.

Benign oral vascular lesions treated by sclerotherapy with ethanolamine oleate: A retrospective study of 43 patients

Background: Although sclerotherapy is a common treatment for benign oral vascular lesions, there is no well standardized protocol for this purpose. The aim of the present study was to describe the clinical characteristics of patients treated by sclerotherapy with ethanolamine oleate (EO), in order to contribute to a better understanding of this technique. Material and Methods: Medical records and images of 90 patients treated by the same sclerotherapy protocol were retrieved and analysed. Thus, 43 cases with complete information were selected and described. Results: The most affected age group was 41-70 years, with a female predominance and 86% of patients being Caucasian. Lips were the most affect site (70%) followed by the tongue (16%). Regarding clinical appearance, approximately 90% of lesions were classified as nodules, and 90% of patients reported no pain. Approximately 40% of lesions were 0.5-1.0 cm in size. In 58% of the patients, only one application of ethanolamine oleate was necessary. The application doses varied according to the lesion size and number of applications. Complete clinical regression occurred in 91% of cases, whereas 9% showed partial regression. Conclusions: Sclerotherapy with EO is an acceptable, effective and affordable treatment for benign oral vascular lesions (AU)

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Criterios de evaluación odontológica pre-radioterapia y necesidad de tratamiento de las enfermedades orales post-radioterapia en cabeza y cuello / Pre-radiotherapy dental evaluation criteria and treatment needs of oral side effects after head and neck radiotherapy

El objetivo de esta revisión es presentar criterios de evaluación odontológica pre-radioterapia y cuáles son las principales necesidades de tratamiento de estos pacientes después del tratamiento de radiación. Fueron revisados artículos en inglés, español y portugués entre 1995 y 2009 indexados en Pubmed y Scielo. Las palabras claves fueron: cáncer oral y radioterapia, complicaciones de la radioterapia en cabeza y cuello, evaluación oral pre-radioterapia. Los efectos colaterales de la radioterapia en la región de cabeza y cuello pueden ser temporales o tardíos. Aquellos que son tardíos, como la caries de radiación y la osteorradionecrosis pueden estar directamente relacionados con el hecho de no haber realizado una evaluación odontológica previa y pueden afectar severamente la calidad de vida del paciente.La participación del cirujano-dentista en el equipo multidisciplinario y la evaluación odontológica de los pacientes que serán sometidos a radioterapia en la región de cabeza y cuello son de vital importancia en mejorar la calidad de vida post-operatoria de estos pacientes.

The objective of this review is to present pre-radiotherapy evaluation criteria and the main needs for treatment of these patients after the radiation therapy. Were revised articles in English, Spanish and Portuguese language between 1995 and 2009 indexed in Pubmed and Scielo. The keywords were oral cancer and radiotherapy, complications in head and neck radiotherapy, oral pre-radiotherapy evaluation.The adverse complications of radiotherapy in head and neck area could be temporary or late. The late effects, such as radiation caries and osteorradionecrosis could be directly associated with the fact that previous dental evaluation was not performed and can severely affect the post-operatory quality of life. The participation of the dentist in the multidisciplinary team and dental evaluation of the patients that will receive radiotherapy in the head and neck area are of vital importance to improve the post-operatory quality of life of these patients.

Tratamento de líquen plano gengival com gel de propionato de clobetasol: relato de caso / Treatment of gengival lichen planus with clobetasol propionate: case report

O líquen plano é uma condição auto-imune mucocutânea que afeta predominantemente mulheres de meia-idade. Em boca ocorrem com maior freqüência em mucosa jugal e língua. Embora sejam menos comuns, as lesões em gengiva usualmente são sintomáticas e de difícil controle. Dentre as formas de tratamento para as lesões gengivais, melhores resultados têm sido observados com aplicação tópica de corticosteróides, principalmente propionato de dobetasol. O presente relato de caso descreve o uso do gel de propionato de dobetasol em moldeiras para tratamento do líquen plano gengival erosivo.

Lichen planus is an auto-immune mucocutaneaus condition that mainly affects middle-aged women. In mouth they occur more frequently in buccal mucosa and tongue. Although gingival lesions are less common, they are usually symptomatic and of difficult control. Among the treatment farms for gingival lesions, better results have been observed with topic application of corticoid, particularly clobetasol propionate. The present case report describes the use of clobetasol propionate in trays for treatment of erosive gingival lichen planus.

Tratamento odontológico de pacientes portadores de deficiência mental com anestesia geral / Dental treatment of patients with mental disability using general anesthesia

O uso da anestesia geral para o tratamento odontológico em pacientes portadores de deficiência mental é um assunto polêmico e, em geral, desconhecido pelos cirurgiões-dentistas, que, por esse motivo, temem a sua indicação. O artigo apresenta uma revisão da literatura sobre o assunto, mostrando riscos, benefícios e descrições técnicas dessa forma de tratamento nessa classe de pacientes, que vem necessitando cada vez mais de tratamento especializado.

Achados radiográficos em 1.000 pacientes triados para atendimenhto odontológico / Radiographic findings in 1.000 patients screened for dental treatment

A radiografia panorâmica é um exame de imagem que fornece informações gerais, principalmente da mandíbula e maxilas. Sua utilização como auxiliar ao exame físico tem sido estudada há algum tempo. O objetivo deste estudo foi analisar as radiografias panorâmicas de 1.000 pacientes que compareceram à FOP/Unicamp para tratamento odontológico. Os achados radiográficos mais frequentes foram osteoesclerose, velamento sinusal e dentes inclusos e semi-inclusos. Além disso, em alguns casos foram observados dentes supranumerários, agenesia dental e imagens sugestivas de odontoma, displasia óssea florida, cemetoblastoma benigno, cisto de Stafne, cisto dentígero e outros. Sendo assim, julgamos ser importante a realização de radiografia panorâmica de rotina como auxiliar ao plano de tratamento

Infecção pelo HIV na população pediátrica e suas manifestações orofaciais / HIV infection in pediatric population and its orofacial manifestations

A síndrome da imunodeficiencia adquirida (Sida/AIDS) é caracterizada por imunossupressão causada pelo vírus da imunodeficiencia humana humana (HIV) e está associada a infecção oportunistas, neoplasias e manifestações neurológicas. Foi identificada pela primeira vez em crianças em 1983, e mais de 90 por cento dos casos resultam da transmissão vertical. Embora haja muitas similaridades da doença entre adultos e crianças, existe uma série de diferenças, entre elas fatores de risco, meios de transmissão e manifestações orofaciais. Este artigo de revisão ressalta a importância do reconhecimento dessas lesões, as quais são, frequentemente, os primeiros sinais da infecção em crianças. As lesões orofaciais mais comumente encontradas são candidíase, hiperplasia da glândula parótida e linfadenopatia cervical. A identificação dessas alterações pode facilitar o diagnóstico da infecção pelo HIV e estabelecer tratamento adequado, aumentando a sobrevida de crianças soropositivas