Myiasis in maxillofacial region: series of three cases

Introduction: Myiasis is a disease caused by larvae of flies in organs and tissues of man or other vertebrate animals, where they install and evolve as parasites. The human myiasis is common in tropical countries, most frequently affecting rural people, immunocompromised patients and those with psychiatric disorders. It has great destructive potential and needs adequate prevention and treatment for resolution or non-occurrence of this manifestation. Objective: This paper aims to report a series of three cases of patients with presence of myiasis in face: 1) firearm injury postoperative complication in the mandible in a drug user patient; 2) wound after trauma in the region of the upper lip in a patient using illicit drugs; and 3) complication due to poor oral hygiene of a patient with neurological and motor deficits. Case report: The care required by these patients is different because this complication is easily prevented by basic and personal health care, although it represents a complicating factor for surgical procedures and/or dental care. Conclusion: The role of health professionals in patients with special needs and/or drug addiction become sometimes a challenge for dental practice, requiring individualized attention to each patient.

Hiperplasia adenomatoide de glândulas salivares menores: relato de dois casos / Adenomatoid hyperplasia of minor salivary glands: a report of two cases

A hiperplasia adenomatoide de glândulas salivares menores é uma lesão benigna rara que pode ser confundida com outras neoplasias de glândulas salivares. Apresenta-se como um pequeno nódulo firme ou como massa exofítica, geralmente indolor, com mucosa de aparência normal, levemente avermelhada ou azul. Histologicamente, observa-se a presença de agregados acinares relativamente normais e lóbulos da mucosa em maiores quantidades, causando aumento do volume e, por vezes, dor. Relato do caso: São relatatos dois casos de hiperplasia adenomatoide de glândula salivar menor, sendo um em menino de 12 anos de idade, em mucosa bucal esquerda, e o outro em mulher de 44 anos de idade em mucosa labial; uma revisão dos relatos anteriores já descritos na literatura também é apresentada. O aparecimento clínico do tumor é indistinguível em comparação com neoplasia da glândula salivar; assim, o exame patológico é essencial para o diagnóstico definitivo desta patologia. Nos dois casos descritos, o tratamento escolhido foi o acompanhamento clínico após diagnóstico; não foram observadas alterações no período de 2 anos desde a primeira consulta...

Adenomatoid hyperplasia of minor salivary glands is a rare benign lesion that can be mistakenly diagnosed as other types of salivary gland neoplasms. It presents as a small firm nodule or as an exophytic mass, usually painless with normal mucosa, and slightly red or blue. Histologically, aggregates of relatively normal acinar lobule mucosa can be seen in larger amounts than expected, causing increased volume and sometimes pain. Case report: This article describes two cases of adenomatoid hyperplasia of minor salivary glands, the first in the left buccal mucosa of a 12 year-old boy and the second in the labial mucosa of a 44 year-old woman, and a review of previous reports of this pathology in English literature. The clinical appearance of the tumor is indistinguishable from salivary gland neoplasms and pathological examination is therefore essential for definitive diagnosis of this pathology. In both cases the treatment chosen after diagnosis was follow up and no changes were observed over 2 years from the first appointment...

Prevalence of oral lesions in elderly patients on oral cancer prevention campaigns in Paraná state Brazil 1989-2013 / Prevalência de lesões orais em pacientes idosos atendidos em campanhas de prevenção de câncer bucal no estado do Paraná, Brasil entre 1989 - 2013

Objective: recently, there has been a rapid aging process of the world population. Despite of a longer permanence of natural teeth and a reduction of oral diseases caused by the improvement of life conditions and the provision of health care, the prevalence of oral diseases in the elderly is still considered significant. Therefore, the aim of this study is to evaluate the epidemiological profile of elderly patients (above 60 years old) attended in 25 years of campaigns oral cancer prevention in the Paraná state, Brazil, between 1989 and 2013. Material and Methods: Patients, volunteers, were evaluated during 25 years of oral cancer prevention by the campaign team and all patients were evaluated in a methodical way with inspection of all intra-oral areas. Results: a total of 22,909 patients were attended during the 25 years of projects. Of these, 6,134 were older than 60 years old, with appearance of 1,523 oral lesions during the examination and 4,611 patients had no oral alterations during the dentist evaluation, among those were found injuries by traumatic origin, inflammatory lesions and others types of injury. Conclusion: it is clear the necessity for specialized care and active surveillance of these patients, since it is a consensus in the literature that the best treatment is early diagnosis. It is also necessary the development of epidemiological studies of the elderly population, which are scarce and difficult to elaboration of plans for effective action to meet the specific demands of this age group.

Objetivo: a população mundial atualmente sofre com um rápido processo de envelhecimento. Apesar de uma maior permanência dos dentes naturais e da redução de doenças bucais causadas pela melhoria das condições de vida e da prestação de cuidados de saúde, a prevalência de doenças bucais em idosos ainda é considerado significativa. Portanto, o objetivo deste estudo é avaliar o perfil epidemiológico dos pacientes idosos (acima de 60 anos) que foram atendidos em 25 anos de campanhas de prevenção do câncer de boca no estado do Paraná, Brasil, entre 1989 e 2013. Material e Métodos: Os pacientes foram selecionados voluntariamente e avaliados durante 25 anos de prevenção de câncer bucal pela equipe participante, os quais foram avaliados de forma metódica com a inspeção de todas as áreas intra-orais. Resultados: um total de 22.909 pacientes foram atendidos durante os 25 anos de projetos. Destes, 6.134 tinham mais de 60 anos, com presença de 1.523 pacientes com lesões orais durante o exame e 4.611 pacientes sem alterações orais durante a avaliação do dentista. As lesões encontradas tinham origem traumática, inflamatórias e outras. Conclusão: é evidente a necessidade de atendimento especializado e da busca ativa desses pacientes, uma vez que é um consenso na literatura de que o melhor tratamento de lesões orais é o diagnóstico precoce. Também é necessário o desenvolvimento de estudos epidemiológicos da população idosa, que são escassos e difíceis de elaboração assim como a realização de planos de ação eficazes para atender às demandas específicas desta faixa etária.

Large desmoplastic fibroma: case report using microvascularized fibula graft for reconstruction / Fibroma desmoplásico de grandes proporções: relato de caso usando enxerto microvascularizado de fibula para reconstrução

The Desmoplastic Fibroma is a benign rare tumor of fibroblastic origin, representing only 0.03% of benign bone tumors. Displays aggressive behavior and high rates of recurrence, which makes the treatment more aggressive. The authors present a case of an 11 years-old female, complaining of increased volume in the jaw. The patient had an extensive swelling of the left mandibular body with invasion of the border of the tongue and floor of the mouth at the same side. She had a history of 4 recurrences at the same site. Image exams revealed expansive lesion in body and ramus of the mandible with involvement of soft tissue on the lingual side of the lesion. The treatment was excision of the lesion with extra oral access and reconstruction with microvascularized fibula graft. The patient has been followed for 2 years with no clinical or radiographic signs and without recurrence

O Fibroma Desmoplásico é um tumor benigno raro de origem fibroblástica que representa apenas 0,03% dos tumores ósseos benignos. Apresenta comportamento agressivo e elevadas taxas de recorrência, o que torna o seu tratamento mais agressivo. Os autores apresentam um relato de caso de uma paciente do sexo feminino de 11 anos de idade com queixa de aumento de volume em mandíbula. A mesma apresentou extensa expansão do corpo mandibular esquerdo, com invasão da borda da língua e assoalho da boca do mesmo lado, com histórico de quatro recorrências na mesma localização. Os exames de imagem revelaram lesão expansiva no corpo e ramo da mandíbula com envolvimento dos tecidos moles do lado lingual da lesão. O tratamento foi a excisão da lesão com acesso extra-oral e reconstrução com enxerto microvascularizado de fíbula. A paciente apresenta seguimento de 2 anos sem sinais clínicos ou radiográficos de recidiva.

Implications of the use of bisphosphonates in dental treatment - experience of the service of oral and maxillofacial surgery, Erasto Gaertner Hospital, Curitiba, Brazil

Introduction: Bisphosphonates (BP) are effective drugs in the prevention and treatment of various bone pathologies, acting in the regulation of osteoclast function through different mechanisms. Despite the success in the treatment of various diseases, these drugs have the ability to induce an avascular necrosis of bone tissue, especially in the maxilla and mandible. Objective: Due the significant increase number of cases of patients with oral complications associated with BP therapy in the Department of Oral and Maxillofacial Surgery of the Erasto Gaertner Hospital, the study aimed to report our experience in the care of these patients. Material and methods: Patients submitted to BP therapy were enrolled prospectively between the years of 2011 and 2012. Clinical examination was performed in all patients to evaluate dental health as well oral mucosa. All patients are under follow-up in our service. Results: 26 patients who used BP were attended in the ambulatory. Twenty-three patients used BP for oncological indication and three for osteoporosis. Most of patients were women (6666%) with average age of 56 years old. The most frequent medication used was Pamidronate (54%), followed by Zoledronic acid (30%) and Alendronate (15%). Ten patients showed bone exposition, most of then in the mandible (80%), with an average time of one year of exposure. Conclusion: Dentists should advise their patients about the use of BP and the implications for oral health and treatments. These patients must have periodic consultations for evaluation and early detection of osteonecrosis associated to BP for adequate treatment.

Survey on jaw fractures occurring due to domestic violence against women

Introduction: Violence against women has become a public health problem, and the dentist is the main responsible for the treatment of their victims, since numerous cases with a high incidence of impaired maxillomandibular complex occurred. Objective: The aim of this study was to analyze the prevalence and evolution of jaw fractures in woman due to domestic violence. Material and methods: The medical files from the Hospital and Maternity of São José dos Pinhais/PR (HMSJP) was searched for female patients diagnosed with jaw fractures caused by trauma, considering the aggressor and the prevalence in the period from January 2001 to May 2003. Results: There were 23 women with jaw fractures, aged from 15 to 43 years. Nasal fractures were the most prevalent, followed by the zygomatic complex and mandible fractures. The husbands were the main responsible for the attacks. The fractures treated by reduction had satisfactory bone consolidation. Conclusion: Patients with jaw fractures had favorable bone consolidation after being submitted to surgical treatment. Nasal fractures were the most prevalent type and the husband was most responsible for the attacks.