Tratamento cirúrgico de sialólito no ducto da parótida: relato de caso / Surgical treatment of sialolite in the duct of the parotid: case report / Tratamiento quirúrgico de sialolito en el conducto del parótido: reporte de caso

Introdução: Os sialólitos são lesões mineralizadas nas glândulas salivares que causam obstrução total ou parcial do ducto, acometendo comumente a glândula submandibular. Sua abordagem varia de pouco invasiva à cirúrgicas, a depender do número, localização e dimensões dos cálculos. Objetivo: Esse estudo teve como objetivo relatar um caso clínico raro de sialólito no ducto da glândula parótida tratado através da remoção cirúrgica. Relato De Caso: Paciente compareceu ao ambulatório com história de dor e edema em face com 2 meses de evolução, referindo piora da sintomatologia após alimentação. Ao exame físico apresentou edema endurecido em região pré-auricular esquerda e ausência de drenagem no ducto da parótida ipsilateral. Foi realizado uma radiografia de tecidos moles com filme periapical, que revelou imagem radiopaca circunscrita sugestiva de um sialólito no ducto da glândula parótida esquerda. Assim, foi realizada excisão cirúrgica do cálculo seguida do reestabelecimento da patência ductal através da instalação de cateter venoso. Paciente evoluiu bem e segue em acompanhamento sem recidiva dos sinais e sintomas. Considerações Finais: O presente estudo revela que o diagnóstico precoce da sialolitíase e a escolha do plano de tratamento adequado estão associados a um bom prognóstico, e o reestabelecimento da patência ductal, quando danificado, é imprescindível para o sucesso do tratamento(AU)

Introduction: Sialoliths are mineralized lesions in the salivary glands that cause total or partial obstruction of the duct, commonly affecting the submandibular gland. It ranges from less invasive to surgical approach, depending on the number, location and dimension of the calculi. Objective: This study aimed to report a rare clinical case of a sialolith in the parotid gland's duct treated by surgical removal. Case Report: The patient attended the outpatient clinic with a history of pain and edema in the face with 2 months of evolution, reporting worsening symptoms after feeding. On physical examination, he had hardened edema in the left preauricular region and no drainage in the ipsilateral parotid duct. Soft tissue radiography with a periapical film was performed, which revealed a circumscribed radiopaque image suggestive of a sialolith in the left parotid gland's duct. Thus, the calculus's surgical excision was performed, followed by the reestablishment of the ductal patency through the installation of a venous catheter. The patient evolved well and is being followed up without recurrence of signs and symptoms. Final Considerations: The present study reveals that the early diagnosis of sialolithiasis and the choice of the appropriate treatment plan are associated with a good prognosis, and the reestablishment of ductal patency, when damaged, is essential for the success of the treatment(AU)

Introducción: Os sialolitos son lesiones mineralizadas en las glándulas salivales que causan obstrucción total o parcial del conducto, afectando comúnmente a la glándula submandibular. Su abordaje varía desde poco invasivo hasta quirúrgico, dependiendo del número, ubicación y dimensiones de los cálculos. Objetivo: Este estudio tuvo como objetivo reportar un caso clínico raro de sialolito en el conducto de la glándula parótida tratado mediante extirpación quirúrgica. Reporte de Caso: Paciente acudió a consulta externa con antecedente de dolor y edema en el rostro de 2 meses de evolución, refiriendo empeoramiento de la sintomatología tras la alimentación. A la exploración física presentaba edema endurecido en región preauricular izquierda y ausencia de drenaje en conducto parotídeo ipsilateral. Se realizó una radiografía de partes blandas con placa periapical, que reveló una imagen radiopaca circunscrita sugestiva de un sialolito en el conducto de la glándula parótida izquierda. Así, se realizó la escisión quirúrgica del cálculo seguida del restablecimiento de la permeabilidad ductal mediante la instalación de un catéter venoso. El paciente evolucionó bien y se le está dando seguimiento sin recurrencia de signos y síntomas. Consideraciones Finales: El presente estudio revela que el diagnóstico precoz de la sialolitiasis y la elección del plan de tratamiento adecuado se asocian a un buen pronóstico, y el restablecimiento de la permeabilidad ductal, en caso de daño, es fundamental para el éxito del tratamiento(AU)

Erosive potential of powdered juice drinks on dental enamel.

This study aimed to evaluate the erosive potential of powdered juice drinks on dental enamel in 2 stages: physiochemical characterization and erosive challenge testing. In stage 1, the pH and titratable acidity of 5 commercially available powdered juices in 10 different flavors were analyzed. Five treatment groups were then established based on the pH values, titratable acidity, and presence of citric acid in the juices, and their energy-dispersive X-ray (EDX) spectroscopy profiles were studied. In stage 2, the erosive effect of the juices was tested using a pH cycling model; polished bovine dental enamel blocks (n = 8) were treated 4 times daily on 5 consecutive days with 1% citric acid (positive control) or lemon, orange, pineapple, or cashew juice. The specimens were immersed in the erosive solutions, under agitation (100 rpm), for 1 minute at 25°C. Overnight and between treatments, the blocks were stored in artificial saliva without agitation. At the end of cycling, the enamel surfaces were evaluated by profilometry and scanning electron microscopy. The stage 2 results were submitted to 1-way analysis of variance followed by Tukey test (α = 0.05). The pH values of the juices ranged between 2.86 (lemon) and 3.84 (cashew), while the titratable acidity ranged from 14.5 (cashew) to 90.00 (lemon) mmol/L. Lemon juice showed the least calcium content (2.76%) and no (0.00%) phosphorus concentration. Orange, pineapple, and cashew juices showed the greatest concentrations of calcium and phosphorus and were therefore less erosive than lemon juice. The mean [SD] surface loss was higher in the lemon juice group (0.52 [0.16] µm), with no significant differences (P > 0.05) from the control (0.39 [0.09] µm) and orange juice (0.41 [0.12] µm). In groups exposed to pineapple juice (0.36 [0.04] µm) and cashew juice (0.16 [0.08] µm), the surface loss was significantly lower (P < 0.05) than that found in lemon juice. The results demonstrate that powdered juice drinks (especially lemon juice) present erosive potential and lead to surface loss of dental enamel.