Surgical Management of Palatal Pleomorphic Adenoma (PPA) Recurrence After 10 years, Treated at a Brazilian Center - A Case Report.

Pleomorphic adenoma, considered the most frequent benign mixed neoplasm of the minor salivary glands, occurs mainly in the region of the hard palate, with slight predilection in females and peak of incidence between the third and fifth decades of life. An increase in recurrence rates has been associated with the histopathological variants of the tumor, cellular characteristics, stroma, and capsule rupture during surgical removal of the lesion. The present case report aims to describe the surgical approach performed on the patient, a 45-year-old woman with a recurrent Pleomorphic Adenoma (PA) in the region of the hard palate on the right side, 10 years after initial enucleation of the lesion; her main complaint was an increase in volume in the palatal region. After extensive local surgical excision of the tumor and 2 years of follow-up, there were no signs of recurrence. Computed tomography and a correct histopathological diagnosis are essential to enable the establishment of an appropriate surgical treatment, with the purpose of achieving complete removal of the lesion, with wide surgical margins, including the lining mucosa and the underlying periosteum, as described in the present case.

On the understanding of zinc-oxide eugenol cement use prior to etch-rinse bonding strategies.

CONTEXT: Zinc-oxide eugenol (ZOE) is frequently used due to its satisfactory biological response, sedative effect on the pulp, and easy removal. However, literature is very controversial about the influence of the temporary cement-containing eugenol on the bond strength properties. AIMS: This study aims to clarify the literature controversy by evaluating the bond strength of ZOE or ZOE-free applied before bonding procedures and the 7-day resting period after the first session. SETTINGS AND DESIGNS: Twelve recently extracted third molars were randomly divided into three groups: Group 1: Control (without treatment), Group 2: Temp-Bond NE; Group 3: Temp-Bond. SUBJECTS AND METHODS: After temporary restorations, the teeth were immersed in distilled water and stored for 7 days at 37°C. The temporary cement was mechanically removed, and prophylaxis was performed. The adhesive procedures were performed, and a 6-mm-high composite resin block was built. The teeth were immediately stored at 100% relative humidity at 37°C for 24 hours. Specimens with 0.7 (±0.2) mm2 of cross-sectional area were obtained and subjected to a microtensile bond strength (µTBS) test at 1 mm/min until failure. STATISTICAL ANALYSIS USED: Analysis of variance (ANOVA) and Tukey's post hoc test were used for statistical analysis. RESULTS: ZOE or ZOE-free cement did not interfere in the µTBS between resin composite and dentine when used with a two-step-etch-rinse adhesive material, considering 7 days of resting period after the first session, by the ANOVA and Tukey's post hoc test (P < 0.05). CONCLUSIONS: The authors recommend the removal of the temporary cementation at least seven days after the first session and suggest that the clinicians follow-up further studies to use the cement in case its removal is recommended within a longer period.