Palatal obturator prosthesis: case series / Prótese obturadora palatina: série de casos

ABSTRACT Surgical treatment for palate cancers can result in oral-nasal/sinus communication, which impairs the swallowing, speech and chewing ability of patients with reflux of ingested food into the nasal cavity, reducing their quality of life. This article aims to report how three cancer patients, with different types of palate cancer undergoing partial maxillectomy with oroantral or oral-nasal communication as postoperative sequelae were prosthetically rehabilitated from 2009 to 2015. The prostheses were made by dental-surgeons interns in the service of the Multidisciplinary Residency in Oncological Healthcare of the Hospital School of the Federal University of Pelotas (HE/UFPel). One of the patients is completely edentulous, the second partially toothed and in the third case the patient is totally toothed, only requiring the obturator. The creation of prosthetic rehabilitation followed the steps of conventional prostheses, especially observing the particularities in the planning, molding, installation and adjustment stages of the prosthesis. In all cases there was improvement on speech immediately after the prosthesis installation and patients reported greater ease to feed.

RESUMO O tratamento cirúrgico para os cânceres de palato pode resultar em comunicação buco-nasal/sinusal, o que interfere negativamente na capacidade de deglutição, fonação e mastigação dos pacientes, com refluxo dos alimentos ingeridos para a cavidade nasal, reduzindo sua qualidade de vida. Neste artigo, objetiva-se relatar como foram reabilitados proteticamente, no período de 2011 a 2015, três pacientes oncológicos com diferentes tipos de câncer de palato submetidos à maxilectomia parcial com comunicação buco-sinusal ou buco-nasal como sequela pós-operatória. As próteses foram confeccionadas por Cirurgiões-dentistas residentes no serviço de Residência Multiprofissional em Atenção à Saúde Oncológica do Hospital Escola da Universidade Federal de Pelotas (HE/UFPel). Um dos pacientes é edêntulo total, o segundo é dentado parcial e no terceiro caso a paciente é totalmente dentada, necessitando apenas do obturador. A confecção das próteses obturadoras seguiu as etapas das próteses convencionais, observadas particularidades principalmente nas fases de planejamento, moldagem e instalação e adaptação da prótese. Em todos os casos observou-se melhora na fala imediatamente à instalação da prótese e os pacientes relataram maior facilidade ao se alimentar.

Sclerotherapy for vascular malformations in the oral and maxillofacial region: treatment and follow-up of 66 lesions.

PURPOSE: The aim of the present study was to relate the use of 5% monoethanolamine oleate in sclerotherapy for vascular malformations and to suggest a protocol for its use. PATIENTS AND METHODS: A total of 53 patients with 66 vascular malformation lesions were treated with an intralesional injection of 5% monoethanolamine oleate at 0.1 mL/cm of lesion with at least a 15-day interval and as many as 4 applications. A descriptive statistical analysis was performed using SigmaPlot, version 9.0, software. RESULTS: The treatment with the protocol suggested was effective in 65 cases, and in 1 case, surgical intervention was required. CONCLUSIONS: Sclerotherapy was effective in the treatment of vascular malformations, and the method chosen was adequate for lesion resolution without complications.

DNA ploidy in oral lichen planus, determined by image cytometry.

BACKGROUND: The objective of this study was to use image cytometry to determine the degree and frequency of DNA ploidy in biopsies of reticular and atrophic-erosive oral lichen planus and to analyze 14 karyometric measurements of the nuclei of epithelial cells from each specimen. METHODS: A total of 40 slides were analyzed, each of them representing one biopsy of one oral lichen planus (OLP) lesion from each one of the 40 patients (cases) studied. Specimens were embedded in paraffin and comprised 20 slides of reticular oral lichen planus (group R) and 20 slides of atrophic-erosive oral lichen planus (group AE). RESULTS: Group R, the reticular lichen samples, had 18 diploid cases and two aneuploid cases. Group AE, the atrophic-erosive lichen samples, had 10 diploid cases, one tetraploid case, and nine aneuploid cases. Of the 14 karyometric measurements of the nuclei of OLP epithelial cells analyzed, the group R mean values for mean density and minimum density were significantly greater than the group AE mean values, and mean roundness in group AE was significantly greater than in group R (t-test: P < 0.05). CONCLUSIONS: The most common degree of DNA ploidy in OLP lesions was diploidy. Comparing the two groups (chi-square test of association P = 0.021) demonstrated that diploidy was associated with the reticular clinical form of OLP, while aneuploidy was associated with the atrophic-erosive clinical form of oral lichen planus.

Oral erythroplakia and speckled leukoplakia: retrospective analysis of 13 cases.

UNLABELLED: Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation. AIM: A retrospective analysis was conducted to investigate the clinicopathologic features of 13 cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and Histopathological diagnosis of oral diseases. MATERIALS AND METHODS: All cases diagnosed with erythroplakia and speckled leukoplakia between 1978 and 2006 were retrieved from the service archives. RESULTS: The lesions exhibited a predilection for males with a female-to-male ratio of 1:3.3. Mean age was 57 years old and soft palate was the site affected in 77% of the cases. Pain symptoms were reported by 61.5% of the patients and association with risk factors such as smoking and excessive alcohol intake was seen in 100% and in 46% of the cases, respectively. The lesions showed epithelial dysplasia, where more than 50% were diagnosed as in situ or invasive carcinoma. CONCLUSIONS: Despite low prevalence, oral homogeneous erythroplakia and speckled leukoplakia show Histopathological alterations vary from epithelial dysplasia to invasive carcinoma. These lesions must be included among those oral lesions with the highest potential for malignant tranformation.

Eritroplasia e leucoeritroplasia oral: análise retrospectiva de 13 casos / Oral erythroplakia and speckled leukoplakia: retrospective analysis of 13 cases

Eritroplasia e leucoeritroplasia são lesões orais cancerizáveis com elevado potencial de transformação maligna. OBJETIVOS: Neste estudo retrospectivo foram analisadas as características clínico-patológicas de 13 casos de eritroplasias e leucoeritroplasias orais de pacientes atendidos em um Serviço especializado em Estomatologia e diagnóstico histopatológico. MATERIAL E MÉTODO: Foram revisados os registros de biópsia de pacientes atendidos entre os anos de 1978 e 2006. Foram registradas e características clínicas e histopatológicas das lesões, bem como sexo, idade dos pacientes e associação com fatores de risco. RESULTADOS: As lesões exibiram predileção por pacientes do sexo masculino na proporção de 1:3.3. A média etária dos indivíduos foi de 57 anos e o palato mole foi o sítio envolvido em 77 por cento dos casos. Sintomatologia dolorosa foi relatada por 61,5 por cento dos pacientes e associação com tabagismo e etilismo foi observada em 100 por cento e em 46 por cento dos casos, respectivamente. As lesões analisadas exibiam displasia epitelial e mais de 50 por cento foram diagnosticadas como carcinoma in situ ou carcinoma invasivo. CONCLUSÕES: Apesar de apresentarem baixa prevalência, as eritroplasias homogêneas e as leucoplasias salpicadas exibem alterações epiteliais que vão de displasia epitelial a carcinoma invasivo, o que justifica sua inclusão entre as lesões bucais com maior potencial de malignização.

Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation. AIM: A retrospective analysis was conducted to investigate the clinicopathologic features of 13 cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and Histopathological diagnosis of oral diseases. MATERIALS AND METHODS: All cases diagnosed with erythroplakia and speckled leukoplakia between 1978 and 2006 were retrieved from the service archives. RESULTS: The lesions exhibited a predilection for males with a female-to-male ratio of 1:3.3. Mean age was 57 years old and soft palate was the site affected in 77 percent of the cases. Pain symptoms were reported by 61.5 percent of the patients and association with risk factors such as smoking and excessive alcohol intake was seen in 100 percent and in 46 percent of the cases, respectively. The lesions showed epithelial dysplasia, where more than 50 percent were diagnosed as in situ or invasive carcinoma. CONCLUSIONS: Despite low prevalence, oral homogeneous erythroplakia and speckled leukoplakia show Histopathological alterations vary from epithelial dysplasia to invasive carcinoma. These lesions must be included among those oral lesions with the highest potential for malignant tranformation.

Vermilionectomy: a treatment alternative for actinic cheilitis / Vermelhectomia: uma opção de tratamento para queilite actínica

Purpose: Ultraviolet radiation is the main etiological agent associated with the development of actinic cheilitis, a premalignant irreversible disease that frequently affects the vermilion border of the lower lip. This paper aimed to describe the case of a patient with actinic cheilitis and treated with scalpel vermilionectomy. Case Description: A male, Caucasian, 66 year-old subject sought dental treatment complaining of "wounds on the lip that not heal" for approximately 15 years. The patient reported that he had worked in farms since the age of 5 year-old and was a frequent user of alcohol and tobacco. Atrophic and erosive areas associated with many ulcers covered with eschars were observed throughout the length of the lip. Based on the patient history and clinical exam, scalpel vermilionectomy was proposed. The histopathological analysis revealed a superficially invasive squamous cell carcinoma with free borders. The patient was monitored for two years with no relapse. Conclusion: Scapel vermilionectomy was chose to treat this case due to its low cost, relatively short time for repair, and possibility of histopathological analysis of the removed tissue.

Objetivo: A radiação ultravioleta é o principal agente etiológico associado ao desenvolvimento da queilite actínica, uma lesão pré-maligna que afeta o lábio inferior. Este trabalho descreveu o caso clínico de um paciente que apresentava várias ulcerações recobertas por crosta no lábio inferior e foi tratado pela técnica da vermelhectomia. Descrição do caso: Um sujeito do sexo masculino, Caucasiano, de 66 anos de idade, procurou tratamento odontológico com queixa de "feridas no lábio que não cicatrizavam" por 15 anos. O paciente relatou que tinha trabalhado em fazendas desde os 5 anos de idade e fazia uso frequente de tabaco e álcool. Áreas erosivas e atróficas associadas a múltiplas úlceras cobertas com escaras foram observadas em todo o lábio. Com base na história do paciente e exame clínico, foi proposto tratamento por vermelhectomia. O diagnóstico histopatológico foi de carcinoma espinocelular superficialmente invasivo, com margens livres, e o paciente foi acompanhado por um período de 2 anos sem recidiva. Conclusão: A técnica da vermelhectomia foi a escolha preferencial de tratamento por ser de baixo custo, ter um tempo cicatricial relativamente curto e, especialmente, permitir que o tecido removido possa ser examinado histopatologicamente.

Cirurgia parendodôntica com obturação simultânea dos canais radiculares: relato de caso clínico / Endodontic surgery with simultaneous roots filling: report of clinical case

A obturação do canal radicular simultânea ao ato cirúrgico está indicada nos casos em que o tratamento endodôntico convencional fracassou, não havendo regressão da lesão periapical, ou quando não é possível a obturação dos canais radiculares devido à presença de exsudação persistente. O presente caso clínico visa a relatar a técnica de obturação do canal radicular simultânea ao ato cirúrgico, bem como enfatizar os passos operatórios a serem seguidos para obtenção do sucesso operatório.

Cirurgia parendodôntica como btura-ção siml-tânea dos canais radicualre / Endodontic surgery with simultaneous roots filling: report of clinical case

A obturação do canal radicular simultânea ao ato cirúrgico está indicada nos casos em que o tratamento endodôntico convencional fracassou, não havendo regressão da lesão periapical, ou quando não é possível a obturação dos canais radiculares devido a presença de exsudação persistente. O presente caso clínico visa relatar a técnica de obturação do canal radicular simultânea ao ato cirúrgico, bem como, enfatizar os passos operatórios a serem seguidos para obtenção do sucesso operatório.