Abordaje quirúrgico conservador para el tratamiento del queratoquiste odontogénico / Conservative surgical approach for the treatment of odontogenic keratocyst

Introduction: The odontogenic keratocyst was recently reclassified in 2017 by the World Health Organization as a cystic lesion of epithelial development derived from the enamel organ or the dental lamina. It shows common characteristics to cysts such as slow and continuous growth; however, it arouses attention for its high aggressiveness and recurrence rate. Objective: To show marsupialization followed by enucleation as a definitive treatment of odontogenic keratocysts. Clinical case: A 63-year-oldwoman with odontogenic keratocyst on the left side of the mandible, treated by the marsupialization technique followed by enucleation. Conclusions: Although there are various treatment options, the dental surgeon may prefer the conservative method in the approach of the odontogenic keratocyst, because it presents the lowest rate of morbidity and relapse within the standards presented in the literature(AU)

Introducción: el queratoquiste odontogénico fue reclasificado en 2017 por la Organización Mundial de la Salud como una lesión cística de desarrollo epitelial, derivado del órgano del esmalte o de la lámina dental. Presenta características comunes a quistes, como crecimiento lento y continuo, sin embargo, llama la atención por su alta agresividad y tasa de recurrencia. Objetivo: describir la marsupialización seguida de enucleación como un tratamiento definitivo para el queratoquiste odontogénico. Presentación del caso: mujer de 63 años con queratoquiste odontogénico en el lado izquierdo de la mandíbula, tratado por la técnica de marsupialización seguido de enucleación. Conclusiones: a pesar de diferentes opciones de tratamientos existentes, el método conservador puede ser el tratamiento de elección del cirujano-dentista en el abordaje del queratoquiste odontogénico, pues presenta la menor tasa de morbilidad y recidiva dentro de los patrones mostrados en la literatura(AU)

Abordaje quirúrgico conservador para el tratamiento del queratoquiste odontogénico / Conservative surgical approach for the treatment of odontogenic keratocyst

Introduction: The odontogenic keratocyst was recently reclassified in 2017 by the World Health Organization as a cystic lesion of epithelial development derived from the enamel organ or the dental lamina. It shows common characteristics to cysts such as slow and continuous growth; however, it arouses attention for its high aggressiveness and recurrence rate. Objective: To show marsupialization followed by enucleation as a definitive treatment of odontogenic keratocysts. Clinical case: A 63-year-oldwoman with odontogenic keratocyst on the left side of the mandible, treated by the marsupialization technique followed by enucleation. Conclusions: Although there are various treatment options, the dental surgeon may prefer the conservative method in the approach of the odontogenic keratocyst, because it presents the lowest rate of morbidity and relapse within the standards presented in the literature(AU)

Introducción: el queratoquiste odontogénico fue reclasificado en 2017 por la Organización Mundial de la Salud como una lesión cística de desarrollo epitelial, derivado del órgano del esmalte o de la lámina dental. Presenta características comunes a quistes, como crecimiento lento y continuo, sin embargo, llama la atención por su alta agresividad y tasa de recurrencia. Objetivo: describir la marsupialización seguida de enucleación como un tratamiento definitivo para el queratoquiste odontogénico. Presentación del caso: mujer de 63 años con queratoquiste odontogénico en el lado izquierdo de la mandíbula, tratado por la técnica de marsupialización seguido de enucleación. Conclusiones: a pesar de diferentes opciones de tratamientos existentes, el método conservador puede ser el tratamiento de elección del cirujano-dentista en el abordaje del queratoquiste odontogénico, pues presenta la menor tasa de morbilidad y recidiva dentro de los patrones mostrados en la literatura(AU)

Congenital oral synechia and ankyloblepharon filiforme adnatum: Case report and literature review.

INTRODUCTION: Congenital intraoral synechias are adhesions of intraoral structures involving soft tissue. These conditions and another anomaly called ankyloblepharon filiforme adnatum, which is partial fusion of the eyelid margins by bands of tissue, are rarely reported in the literature. The association of both anomalies of the craniomaxillofacial region is an even more unusual finding. PURPOSE: This article adds more information to the literature by reporting a case of a neonate with a rare association of bilateral synechia between the jaws, fusion of buccal mucosa to the ridges and between the tongue and palate, and ankyloblepharon filiforme adnatum in both eyes, without any other facial or systemic malformation. METHODS: A literature review of similar cases published in PUBMED/MEDLINE was conducted followed by a discussion and comparison to the new case. CONCLUSION: The rare association of these congenital defects, without the presence of syndromic symptoms, could be diagnosed and treated easily with good prognostic evolution.

Involvement of oral tissues by AL amyloidosis: a literature review and report of eight new cases.

OBJECTIVE: Amyloidosis is a term used to describe a group of diseases in which there is an extracellular deposition of amorphous fibrillar proteins known as amyloid. The aim of this study was to present clinicopathological data from eight oral amyloidosis-affected patients and a deep review of the literature about the disease. MATERIALS AND METHODS: A retrospective study was conducted based on the records of oral amyloidosis-affected patients diagnosed in our institution between 1978 and 2012. The clinicopathological features and immunohistochemical (IHC) staining with anti-kappa and anti-lambda light chain antibodies were carried out and analyzed. RESULTS: Eight patients were diagnosed with the disease; the tongue and women in their sixth decade of life were mostly affected. All lesions demonstrated apple-green birefringence and immunoreactivity for kappa-light chain, and four cases also showed lambda positivity. According to our series, four cases were diagnosed with localized amyloidosis and four with systemic amyloidosis. Prognosis for the systemic ones was gloomy, but good for the localized ones, which was characterized by a slow pattern of deposition without evolution to systemic involvement. CONCLUSIONS: This study reinforces our knowledge about predilections, outcomes, and the importance of making a correct and quick diagnosis of oral amyloidosis and shows the necessity of more studies detailing oral amyloidosis predilection on a global scale. The importance and utility of IHC in the typing of the biochemical nature of amyloid deposits are becoming increasingly necessary for proper management of the patient. Correct classification of the type of amyloid is important for treatment consequences. CLINICAL RELEVANCE: This article highlights the clinicopathological data of patients with amyloidosis affecting oral tissues and compare these new findings with other worldwide descriptions. Because of its rarity, such data are often unfamiliar to most clinicians and pathologists.

Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge.

OBJECTIVE: The goal of this study is to describe 7 cases of clear cell odontogenic carcinoma among a Brazilian population and compare these data with a systematic review of the English-language literature. STUDY DESIGN: Descriptive statististics were used to compare the clinicopathologic data gathered retrospectively with those compiled from a review. Tumor sections were immunostained for Ki-67, p16, p53, and cytokeratins (CKs) 7, 8, 14, 18, and 19. Log-rank tests were performed for survival analysis. RESULTS: Most cases occurred in the posterior mandible (5/7, 71.4%), and recurrence was diagnosed in all treated patients. Metastatic disease occurred in 2 patients (28.6%). Tumors were focally positive for CKs 7, 8, 14, and 18 and diffusely positive for CK19, p53, and p16. The mean number of Ki-67-positive cells was 35.2 cells/high-power field. Our systematic review provided evidence that tumor size (P = .046), histologic pattern (P = .034), regional metastasis (P = .001), distant metastasis (P = .001), and local recurrence (P = .05) were of significant prognostic value. CONCLUSIONS: This study has contributed to improved characterization of clear cell odontogenic carcinoma, which is an aggressive odontogenic malignant neoplasm diagnosed mainly in the posterior mandible of middle-aged women and typically at an advanced stage. Radical surgical procedures remain the gold standard treatment.

Perfil estomatológico de pacientes psoriátricos: análise de 50 casos / Stomatologic feactures in psoriatric patients: analysis of 50 cases

Introdução: a psoríase é uma doença dermatológica crônica que acomete cerca de 3% da população mundial e pode representar um fator importante de exclusão social. A manifestação bucal ainda é um assunto controverso na literatura sendo descrita como lesões brancas, eritematosas, úlceras e papuloescamosa. Objetivos - Avaliar a presença de manifestações bucais da psoríase, considerando-se a localização e as características clínicas das lesões encontradas, o sexo, a idade e a raça dos acometidos. Métodos - Estudo observacional, do tipo transversal, com pacientes que procuraram atendimento no ambulatório de dermatologiado Hospital de Clínicas da Universidade Federal de Uberlândia (HCUFU) entre dezembro de 2006 a novembro de 2007 (n=50). Resultados - A idade variou entre 7 e 78 anos com media de idade de 43,58 anos e mediana de 45 anos. Não houve predileção por sexo, sendo que 26 pacientes eram do sexo masculino e 24 feminino. No exame bucal foram encontradas lesões em 44% dos pacientes, sendo 16 lesões em língua (53,3%) na forma de fissuras ou áreas despapiladas, 2 em mucosa jugal (6,7%) na forma de placas brancas, 5 em lábio (16,7%) na forma de queilites e ressecamento e 7 lesões eritematosa sem palato (23,3%). Conclusões - Não foi possível identificar alteração que pudesse estar associada à psoríase, visto que nenhuma lesão acompanhou o quadro da doença cutâneaou teve diagnóstico histológico confirmado. Com relação às alterações em língua, tais como língua fissurada e língua geográfica, a incidência encontrada foi muito próxima a outros estudos em pacientes sem uma doença de base importante.

Introduction: psoriasis is a chronic dermatologic disease that affects at least 3% of the world population. Oral manifestation is still a controversy in the literature. It has been described by some authors in clinical case reports as white or erythematous lesions, ulcers and descamative papules. Objectives - To evaluate the presence of oral manifestations associated with psoriasis, considering location and clinical characteristics of the lesions and also gender, age and race of patients. Method - It was an observational,cross-sectional study of patients who sought for treatment at the Dermatology Service ofthe University Hospital (Uberlândia Federal University); between December 2006 and November 2007 (n=50) . Results - Age varied from 7 to 78 years, mean age of 43,58years and median of 45 years. There was no predominance of male (n=26) or female(n=24) patients. Lesions were found in 44% of patients, 16 (53,3%) of these lesions werein tongue, 2 (6,7%) white plaques in the cheeks, 5 (16,7%) lesion in lips as cheilitis anddryness and 7 (23,3%) erythematous areas in the hard palate. Conclusions - After all,it was not possible to make any specific association between oral lesions and psoriasis because the lesions did not follow the cutaneous disease stage nor was histologically confirmed. Also the tongue alterations incidence identified in this study was similar tothat found in population without other diseases.