Refractory Pigmentation Associated with Laugier-Hunziker Syndrome following Er:YAG Laser Treatment.

The present report describes a case of Laugier-Hunziker syndrome (LHS), a rare benign condition. A patient with LHS develops acquired melanotic pigmentation of the lips and buccal mucosa, often with pigmentation of the nails occurring. No systemic symptoms are associated with this syndrome. Normally, no treatment is required for this condition, unless for aesthetic reason, mainly due to pigmentation on the lip mucosa. We present a case of LHS, 37-year-old female, whose pigmentations on her lip and in the oral cavity were treated with an Er:YAG laser. At the postoperative 12th month followup, the lesions recurred. The effects of any surgical attempt to treat pigmentations associated with LHS were discussed.

Epidemiologia das infecções maxilofaciaistratadas num hospital público da cidadede São Paulo / Epidemiology of maxillofacial infections treated in a public hospital in the city of Sao Paulo

As infecções maxilofaciais são condições clínicas graves, de ocorrência relativamente comum,caracterizadas pela rápida disseminação do processo infeccioso aos tecidos adjacentes eespaços faciais da região de cabeça e pescoço. Sua causa é geralmente odontogênica. O objetivodeste estudo foi avaliar dados referentes às causas, características clínicas, manifestaçõesclínicas e eficácia do tratamento realizado em 42 pacientes admitidos com infecção maxilofacialno Departamento de Cirurgia Bucomaxilofacial do Hospital Tatuapé, São Paulo, no períodode março de 2005 a fevereiro de 2006. As infecções odontogênicas (83,30/0). com predomíniodas infecções periapicais, foram as principais causas das infecções maxilofaciais. As manifestaçõesclínicas mais comuns encontradas nos registros foram o edema acentuado (97,60f0), trismo(52,40f0) e prostração (47,60f0). Os pacientes diabéticos não compensados apresentaram tempode internação maior quando comparados ao dos pacientes não diabéticos (P = 0,001). Em 76,2%dos casos, o tratamento instituído foi a drenagem cirúrgica complementada por antibioticoterapiaendovenosa e remoção da causa. De acordo com o estudo realizado, pudemos concluirque houve predomínio de infecções maxilofaciais em adultos jovens, sendo as infecções odontogênicasas principais causas. O tratamento empregado foi efetivo na grande maioria dos casos.

Maxillofacial infections are severe clinical processes of relative occurrence characterizedbya rapid spreading of the infection into the neighboring tissues and to the fascial spaces ofthe head and neck region. Its cause is predominantly odontogenic. This study aimed to assess,retrospectively, data concern to the causes, clinical characteristics, clinical manifestations andtreatment efficacy in 42 in-patients with maxillofacial infection at the Department of Oraland Maxillofacial Surgery of Hospital Tatuapé, São Paulo, from March 2005 to February 2006.The odontogenic infections (mainly the periapical infections) accounted for 83.30f0 of the maxillofacialinfections. The most common clinical manifestations were exuberant edema (97.6%),trismus (52.40f0) and prostration (47.60f0). Uncontrolled diabetic patients showed a lonqer-recoveringperiod at the hospital when compared with that of nondiabetic patients (P = 0.001). In76.20f0 of the cases, the treatment proceeding was surgical drainage coupled with antibiotic intravenoustherapy and cause resolution. Summarizing the main findings, this study showed thatmaxillofacial infections occurred mostly in young-adults, with the odontogenic infections beingtheir principal cause. The providing treatment was effective in the great majority of the cases.

Reação liquenoide oral de contato por hipersensibilidade ao amálgama: relato de 5 casos / Orallichenoid contact reaction by hypersensitivity to amolgam: report of 5 cases

Reações liquenoides orais de contato (RLC) resultam predominantemente por mecanismo de hipersensibilidade da mucosa oral a componentes presentes nas restaurações de amálgama, cujas lesões apresentam características clínicas e histopatológicas seme¬lhantes às do líquen plano oral (LPO) idiopático. A diferenciação entre RLC e LPO idiopá¬tico se faz, essencialmente, pela observação da melhora clínica ou desaparecimento das lesões RLC após a substituição das restaurações de amálgama por materiais restauradores não-metálicos. No presente artigo, 5 casos clínicos de RLC são relatados, enfatizando-se o processo de diagnóstico e tratamento.

Lichenoid contact reactions (LCR) occu r mostly as hypersensitivity reactions of the oral mucosa to components of amalgam restorations, with clinical and histopathologic charac¬teristics similar to those of idiopathic orallichen pia nus (OLP). The differentiation betweenl LCR and idiopathic OLP is made mainly by observation of clinical improvement or disappea¬rance of LCR lesions after replacement of amalgam resolutions by non-metallic restorativel materiais. The present article report 5 cases of LCR, in which the diagnostic approach anol treatment are emphasized.

Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer.

The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer

The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

Oral status and Candida colonization in patients with Sjögren's Syndrome.

OBJECTIVE: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candida albicans colonization in several areas of the mouth in patients with primary and secondary Sjögren's syndrome as opposed to those of healthy subjects. STUDY DESIGN: Thirty-seven patients with Sjögren's syndrome (SS), [14 patients with primary SS (SS-1) and 23 patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth, pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prosthetic appliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicans colonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue's dorsal surface were determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test. RESULTS: No statistically significant difference was found between SS-1 and SS-2 groups based on the parameters analysed. Statistically significant differences were observed between patients with SS and healthy subjects in terms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candida carriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only one subject of SS subgroup. CONCLUSIONS: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis. C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization in different areas of the oral cavity in SS patients.

Oral status and Candida colonization in patients with Sjögren’s Syndrome

Objective: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candidaalbicans colonization in several areas of the mouth in patients with primary and secondary Sjögren’s syndrome asopposed to those of healthy subjects.Study design: Thirty-seven patients with Sjögren’s syndrome (SS), [14 patients with primary SS (SS-1) and 23patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth,pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prostheticappliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicanscolonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue’s dorsal surfacewere determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test.Results: No statistically significant difference was found between SS-1 and SS-2 groups based on the parametersanalysed. Statistically significant differences were observed between patients with SS and healthy subjects interms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candidacarriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only onesubject of SS subgroup.Conclusions: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis.C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization indifferent areas of the oral cavity in SS patients (AU)

Double-blind, crossover, placebo-controlled clinical trial with clobetasol propionate in desquamative gingivitis.

The aim of this study was to evaluate the efficacy of a 0.05% clobetasol propionate ointment administered in trays to 22 patients with desquamative gingivitis in a double-blind, crossover, placebo-controlled trial. Patients received container number 1 and were instructed to apply the ointment 3 times a day for 2 weeks, and to reduce the application to once a day in the third week. Next, the patients were then instructed to discontinue the treatment for 2 weeks, and were then given container 2, used in the same way and for the same length of time as container 1. Regarding signs, 17 patients presented some improvement, while 5 experienced worsening with clobetasol propionate. With the placebo, 14 patients presented some improvement, and 8 patients presented worsening. For symptoms, there was complete improvement in 2 patients, partial improvement in 12, no response in 7, and worsening in 1 with clobetasol propionate. With the placebo, there was partial improvement in 8 patients, no response in 12 and worsening in 2. No statistically significant difference was found between clobetasol and placebo (p>0.05). Within the period designed to treat the gingival lesions of the patients, clobetasol propionate did not significantly outperform the placebo.

Systemic treatment in severe cases of recurrent aphthous stomatitis: an open trial.

PURPOSE: This study aimed to evaluate the efficacy of the systemic drugs thalidomide, dapsone, colchicine, and pentoxifylline in the treatment of severe manifestations of RAS. METHODS: An open, 4-year clinical trial was carried out for 21 consecutive patients with severe RAS. Initially, patients were given a 2-week course of prednisone to bring them to a baseline status. Simultaneously, one of the four test drugs was assigned to each patient to be taken for a period of 6 months. During the course of the trial, patients were switched to one of the other three drugs whenever side effects or a lack of satisfactory results occurred, and the 6-month limit of the treatment was then reset. RESULTS: The most efficient and best-tolerated drug was thalidomide, which was administered to a total of eight patients and resulted in complete remission in seven (87.5%). Dapsone was prescribed for a total of nine patients, of whom eight (89%) showed improvement in their symptoms, while five showed complete remission. Colchicine was administered to a total of ten patients, with benefits observed in nine (90%), of whom four showed complete remission. Pentoxyfilline was administered to a total of five patients, with benefits observed in three (60%), of whom one patient showed complete remission. CONCLUSION: The therapeutic methods used in this trial provided significant symptom relief. Patients experienced relapses of the lesions; however, this occurred after withdrawal of their medication during the follow-up period.

Double-blind, crossover, placebo-controlled clinical trial with clobetasol propionate in desquamative gingivitis

The aim of this study was to evaluate the efficacy of a 0.05 percent clobetasol propionate ointment administered in trays to 22 patients with desquamative gingivitis in a double-blind, crossover, placebo-controlled trial. Patients received container number 1 and were instructed to apply the ointment 3 times a day for 2 weeks, and to reduce the application to once a day in the third week. Next, the patients were then instructed to discontinue the treatment for 2 weeks, and were then given container 2, used in the same way and for the same length of time as container 1. Regarding signs, 17 patients presented some improvement, while 5 experienced worsening with clobetasol propionate. With the placebo, 14 patients presented some improvement, and 8 patients presented worsening. For symptoms, there was complete improvement in 2 patients, partial improvement in 12, no response in 7, and worsening in 1 with clobetasol propionate. With the placebo, there was partial improvement in 8 patients, no response in 12 and worsening in 2. No statistically significant difference was found between clobetasol and placebo (p>0.05). Within the period designed to treat the gingival lesions of the patients, clobetasol propionate did not significantly outperform the placebo.

O objetivo deste estudo foi avaliar a eficácia do propionato de clobetasol a 0,05 por cento administrada com moldeiras em 22 pacientes com gengivite descamativa por meio de estudo duplo-cego, cruzado, placebo-controlado. Pacientes receberam bisnaga número 1 e foram instruídos a aplicar a pomada 3 vezes ao dia por um período de 2 semanas, e reduzir a aplicação para 1 vez ao dia na terceira semana. Os pacientes foram instruídos a suspender o tratamento por 2 semanas, e então receberam a bisnaga 2, usando-a da mesma maneira que o container 1. Com relação aos sinais, 17 pacientes apresentaram alguma melhora, enquanto 5 apresentaram piora com o propionato de clobetasol. Com o uso do placebo, 14 pacientes apresentaram alguma melhora, e 8 pacientes apresentaram piora do seu quadro clínico. Com relação aos sintomas, houve completa melhora em 2 pacientes, melhora parcial em 12, ausência de resposta em 7, e piora em 1 pacientes durante o uso do propionato de clobetasol. Com o uso do placebo, houve melhora parcial em 8 pacientes, ausência de resposta em 12 e piora dos sintomas em 2 pacientes. Não foi verificada diferença estatisticamente significante em nenhum dos parâmetros entre o uso do clobetasol e placebo; p>0,05. Baseado no protocolo utilizado neste grupo de pacientes, o propionato de clobetasol não demonstrou efetividade significante quando comparado ao placebo.

Systemic treatment in severe cases of recurrent aphthous stomatitis: an open trial

PURPOSE: This study aimed to evaluate the efficacy of the systemic drugs thalidomide, dapsone, colchicine, and pentoxifylline in the treatment of severe manifestations of RAS. METHODS: An open, 4-year clinical trial was carried out for 21 consecutive patients with severe RAS. Initially, patients were given a 2-week course of prednisone to bring them to a baseline status. Simultaneously, one of the four test drugs was assigned to each patient to be taken for a period of 6 months. During the course of the trial, patients were switched to one of the other three drugs whenever side effects or a lack of satisfactory results occurred, and the 6-month limit of the treatment was then reset. RESULTS: The most efficient and best-tolerated drug was thalidomide, which was administered to a total of eight patients and resulted in complete remission in seven (87.5 percent). Dapsone was prescribed for a total of nine patients, of whom eight (89 percent) showed improvement in their symptoms, while five showed complete remission. Colchicine was administered to a total of ten patients, with benefits observed in nine (90 percent), of whom four showed complete remission. Pentoxyfilline was administered to a total of five patients, with benefits observed in three (60 percent), of whom one patient showed complete remission. CONCLUSION: The therapeutic methods used in this trial provided significant symptom relief. Patients experienced relapses of the lesions; however, this occurred after withdrawal of their medication during the follow-up period.

Líquen plano oral: relação clínico-histopatológica, imunofluorescência direta, associação com medicação sistêmica e terapêutica / Oral lichen planus: clinicohistopathologic correlation, direct immunofluorescence, association with systemic medication and management

Líquen plano (LP) é doença inflamatória crônica de envolvimento mucocutâneo. Lesões orais do líquen plano (LPO) são freqüentes e classicamente reconhecidas pela sua distribuição simétrica e bilateral na mucosa oral. As pesquisas atuais concentram-se sobre critério de diagnóstico do LPO em razão da sua caracterização como doença potencialmente cancerizável. O assunto é controverso, isto porque alguns casos relatados com transformação maligna de LPO não apresentavam características explicitas de LPO, mas, sim, de outras doenças, particularmente a displasia liquenóide. O objetivo deste presente estudo foi investigar correlações clínico-histopatológicas e de imunofluorescência direta (IFD) em pacientes com lesões LPO. Um grupo controle para IFD também foi incluído. Adicionalmente, foi investigada a associação do LPO com medicações sistêmicas, e a análise da resposta terapêutica do LPO. Cinqüenta e nove pacientes (44 mulheres e 15 homens; media de idade 51,7 anos) com lesões sugestivas de LPO foram examinados. O diagnóstico clínico e histopatológico de LPO foram definidos de acordo os critérios estabelecidos pela WHO (1978); a IFD – como suporte ao diagnóstico de LPO – foi definida pela reação fluorescente exclusivamente para anti-fibrinogênio na zona da membrana basal (ZBM). Informações correspondentes à história clínica, medicações sistêmicas, lesões extra-orais e hábitos foram registradas; casos sintomáticos foram tratados preferencialmente com corticosteróides tópicos, mas outras formas terapêuticas foram incluídas. Os resultados mostraram que o diagnóstico clínico característico de LPO foi obtido em 37 pacientes, enquanto em 22 casos o diagnóstico foi LPO versus outra(s) doença(s). Os achados histopatológicos mostraram que 30 casos foram conclusivos de LP, 21 compatíveis com LP e 8 não-LP. Não houve diferença estatisticamente significante entre categorias de diagnósticos clínicos, distribuição uni ou bilateral das lesões e achados histopatológicas (P > 0,05)...

Lichen planus (LP) is a chronic inflammatory disease involving skin and/or mucosa. Oral lesions of lichen planus (OLP) are frequent and recognized by their symmetrical and bilateral distribution in the oral mucosa. Currently, most studies are concerned with the criteria for the diagnosis of OLP, mainly to fact that this disease has been characterized as a pre-malignant condition. This issue is controversial since some cases reported as showing malignant transformation were not in fact OLP, but other diseases, mainly lichenoid dysplasia. The aim of this present study was to investigate clinico-histopathologic correlation and direct immunofluorescence (DIF) in patients with OLP lesions. A control group was also included for DIF analysis. Additionally, data for the association of systemic medication and management of OLP lesions were also provided. Fifty-nine patients (44 women and 15 men; mean age 51.7 years) with suggestive lesions of OLP were examined. Characteristic clinical and histopathologic diagnoses of OLP were made according to the criteria established by WHO (1978). DIF for supporting diagnosis in OLP lesions was defined for positive reaction exclusively with anti-fibrinogen along the basement membrane zone (BMZ). Information regarding medical history, systemic medication, extra-oral lesions and habits were registered; symptomatic lesions were mainly treated with topical corticosteroids, but other forms of treatment were also used. The results showed that clinical diagnosis characteristic of OLP was obtained in 37 patients; whereas in 22 cases the diagnosis was OLP versus other lesion(s). The histopathologic findings showed that 30 cases were conclusive of LP, 21 compatible with LP, and 8 were non-LP; there being no significant difference in respect to the clinical diagnostic categories, unilateral or bilateral distribution of lesions, and histopathologic findings (P > 0.05). DIF in 20 OLP patients, 7 histopathologically conclusive of LP...

Quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms.

This study was aimed at assessing the quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms (MSGN). Twelve patients (10 women and 2 men, mean age: 49.4 years) with histopathologic diagnosis of pleomorphic adenoma (PA, 3 cases), polymorphous low-grade adenocarcinoma (PLGA, 2 cases), cystic adenoid carcinoma (CAC, 4 cases), and muco-epidermoid carcinoma (MEC, 3 cases) were evaluated. All of them were treated by surgical excision; patients with CAC received radiotherapy as well. The patients quality of life was evaluated through a self-administered questionnaire concerning their physical well-being, emotional status, normal daily activities, and family relationships. The results showed that patients with MEC--the youngest among all patients--reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with patients treated for PA (P<0.05), and also of their functional activities as compared with those treated for PA and PLGA (P<0.05). In conclusion, age of development of the neoplasm and type of disease produce more impact on patients quality of life than does the therapys degree of aggression.

Burning mouth syndrome: clinical profile of Brazilian patients and oral carriage of Candida species.

Burning mouth syndrome (BMS) is a complex disease of unknown cause. It is characterized by a burning sensation in the oral mucosa, notwithstanding its clinical normal aspect. BMS is particularly seen in postmenopausal women. The purpose of this study was to investigate this syndrome on a clinical basis and, in addition, to analyze its possible relation to the frequency of Candida species. Thirty-one patients (28 women and 3 men; 13 Caucasians and 18 non-Caucasians; mean age = 61.3, range 30-85 years) were evaluated. Most patients (80.6%) were under long-term medication, antihypertensive, ansiolitic and antidepressant drugs being the most used. Burning mouth complaint was associated with other secondary oral complaints in 83.8% of the cases. Tongue was the most commonly affected site (70.9%), followed by the vermillion border of the lower lip (38.7%) and hard palate (32.2%). The association of the burning sensation with oral cancer (cancer phobia) was reported by 67.7% of the patients. Haematologic examination (hematocrit, haemoglobin and fasting blood glucose level) revealed 2 cases each of anemia and type 2 diabetes. Local factors, tooth extractions and dentures wearing, were associated with the onset of symptoms in 35.5% of the cases. Daily activities were changed as a consequence of BMS in 29% of the patients. Among the species of the genus Candida, C. albicans was the most frequent in BMS patients (9 - 29.03%) and controls (12 - 38.70%), followed respectively by C. parapsilosis (2 - 6.45% and 0 - 0%); C. tropicalis (1 - 3.22% and 2 - 6.45%); C. krusei and C. kefyr (1 - 3.22% and 0 - 0%). Therefore, such difference did not reach valuable results. In conclusion, these data were similar to those reported in other studies. The highlights of the present findings were the possible relation of BMS with chronic drug use, depression, menopause and cancer phobia. No association was found between BMS and the prevalence of Candida species.

Burning mouth syndrome: clinical profile of Brazilian patients and oral carriage of candida species

Burning mouth syndrome (BMS) is a complex disease of unknown cause. It is characterized by a burning sensation in the oral mucosa, notwithstanding its clinical normal aspect. BMS is particularly seen in postmenopausal women. The purpose of this study was to investigate this syndrome on a clinical basis and, in addition, to analyze its possible relation to the frequency of Candida species. Thirty-one patients (28 women and 3 men; 13 Caucasians and 18 non-Caucasians; mean age = 61.3, range 30-85 years) were evaluated. Most patients (80.6 percent) were under long-term medication, antihypertensive, ansiolitic and antidepressant drugs being the most used. Burning mouth complaint was associated with other secondary oral complaints in 83.8 percent of the cases. Tongue was the most commonly affected site (70.9 percent), followed by the vermillion border of the lower lip (38.7 percent) and hard palate (32.2 percent). The association of the burning sensation with oral cancer (cancer phobia) was reported by 67.7 percent of the patients. Haematologic examination (hematocrit, haemoglobin and fasting blood glucose level) revealed 2 cases each of anemia and type 2 diabetes. Local factors, tooth extractions and dentures wearing, were associated with the onset of symptoms in 35.5 percent of the cases. Daily activities were changed as a consequence of BMS in 29 percent of the patients. Among the species of the genus Candida, C. albicans was the most frequent in BMS patients (9 - 29.03 percent) and controls (12 - 38.70 percent), followed respectively by C. parapsilosis (2 - 6.45 percent and 0 - 0 percent); C. tropicalis (1 - 3.22 percent and 2 - 6.45 percent); C. krusei and C. kefyr (1 - 3.22 percent and 0 - 0 percent). Therefore, such difference did not reach valuable results. In conclusion, these data were similar to those reported in other studies. The highlights of the present findings were the possible relation of BMS with chronic drug...

A Síndrome de ardência bucal (SAB) é uma doença complexa, de etiologia desconhecida. Caracteriza-se por uma sensação de queimação na mucosa bucal, não obstante seu aspecto clínico normal, sendo bastante freqüente em mulheres após a menopausa. O propósito deste estudo foi o de investigar a SAB em bases clínicas e, em adição, analisar sua possível relação com a freqüência de espécies do gênero Candida isoladas da cavidade bucal desses indivíduos. Foram estudados trinta e um pacientes, 28 mulheres e 3 homens, 13 caucasianos e 18 não caucasianos, média de idade 61,3 (faixa dos 30 - 85 anos). A maioria deles (80,6 por cento) estava sob medicação por longo período. Anti-hipertensivos, ansioliticos e antidepressivos foram as drogas mais utilizadas. A ardência bucal estava associada a outras queixas secundárias em 83,8 por cento dos pacientes. A língua foi o sítio mais afetado (70,9 por cento), seguida pelo vermelhão do lábio inferior (38,7 por cento) e palato duro (32,2 por cento). A associação de sensação de ardência com câncer bucal (cancerofobia) foi referida por 67,7 por cento dos pacientes. Exames hematológicos (hematócrito, hemoglobina e glicemia em jejum) revelaram dois casos cada, de anemia e diabetes tipo 2. Fatores locais, exodontias, e uso de próteses estavam associados com o conjunto de sintomas em 35,5 por cento dos casos. Foram referidas alterações importantes nas atividades cotidianas, em conseqüência da SAB, em 29 por cento dos pacientes. Leveduras do gênero Candida foram isoladas da cavidade bucal de 45,16 por cento dos indivíduos com SAB e igualmente do grupo-controle, não constituindo dado qualitativamente importante. Dentre as espécies do Gênero Candida, C. albicans foi a mais freqüente (9 - 29,03 por cento e 12 - 38,70 por cento), seguida de C. parapsilosis (2 - 6,45 por cento e 0 - 0 por cento), C. tropicalis (1 - 3,22 por cento e 2 - 6,45 por cento), C. krusei e C. kefyr (1 - 3,22 por cento e 0 - 0 por cento). Em conclusão, nossos...

Quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms

This study was aimed at assessing the quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms (MSGN). Twelve patients (10 women and 2 men, mean age: 49.4 years) with histopathologic diagnosis of pleomorphic adenoma (PA, 3 cases), polymorphous low-grade adenocarcinoma (PLGA, 2 cases), cystic adenoid carcinoma (CAC, 4 cases), and muco-epidermoid carcinoma (MEC, 3 cases) were evaluated. All of them were treated by surgical excision; patients with CAC received radiotherapy as well. The patients’ quality of life was evaluated through a self-administered questionnaire concerning their physical well-being, emotional status, normal daily activities, and family relationships. The results showed that patients with MEC - the youngest among all patients - reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with patients treated for PA (P < 0.05), and also of their functional activities as compared with those treated for PA and PLGA (P < 0.05). In conclusion, age of development of the neoplasm and type of disease produce more impact on patients’ quality of life than does the therapy’s degree of aggression.

Este estudo teve por objetivo avaliar a qualidade de vida em pacientes submetidos a tratamento cirúrgico para neoplasias de glândulas salivares menores (NGSM). Doze pacientes (10 mulheres e 2 homens, idade média de 49,4 anos) com diagnóstico histopatológico de adenoma pleomórfico (AP, 3 casos), adenocarcinoma polimorfo de baixo grau de malignidade (APBG, 2 casos), carcinoma adenóide cístico (CAC, 4 casos), e carcinoma muco-epidermóide (CME, 3 casos) foram avaliados. Todos os pacientes foram tratados por excisão cirúrgica; pacientes com CAC receberam radioterapia complementar. A qualidade de vida dos pacientes foi avaliada através de um questionário de auto-avaliação referente ao bem-estar físico, estado emocional, atividades normais diárias, e relações familiares. Os resultados mostraram que os pacientes com CME - os mais jovens entre todos os pacientes - relataram uma piora significativamente maior em seu bem-estar físico e estado emocional após o tratamento quando comparados com pacientes tratados de AP (P < 0,05), e também em suas atividades funcionais quando comparada com indivíduos tratados de AP e APBG (P < 0,05). Em conclusão, a idade de desenvolvimento da neoplasia e o tipo de doença produzem maior impacto na qualidade de vida do paciente do que faz o grau de agressão do tratamento.

Corticosteróide tópico oclusivo no tratamento de manifestações gengivais de doenças vesicobolhosas auto-imunes / Topical occlusive corticosteroid for the treatment of gingival manifestations of vesicobullous autoimmune diseases

O tratamento das lesões gengivais de doenças vesicobolhosas auto-imunes constitui grande desafio na estomatologia, principalmente pela natureza crônica das lesões. O tratamento sistêmico é necessário no controle das apresentações mais graves; entretanto, quando possível, o tratamento tópico é preferível. Este artigo descreve uma técnica oclusiva para aplicação de corticosteróide tópico que tem demonstrado ser eficaz no controle dessas lesões, sobretudo em pacientes com manifestações exclusivamente gengivais.

Adult T-cell leukemia/lymphoma with predominant bone involvement, initially diagnosed by its oral manifestation: a case report.

Adult T-cell leukemia/lymphoma (ATL/L) is a rare malignant neoplasm linked to human T-cell lymphotropic virus type 1 (HTLV-1). This virus has been identified in Japan, the Caribbean, and, more recently, Brazil. We report a case of ATL/L (lymphoma-type) affecting a 30-year-old Brazilian woman. She presented a painful and ulcerated lesion on her hard palate mucosa. Conventional radiographs and computed tomography revealed the involvement of several bones plus the lung and axillary lymph nodes. Histopathological and immunohistochemical analyses of oral biopsy confirmed a T-cell non-Hodgkin's lymphoma. Final diagnosis of ATL/L was made based on HTLV-1 positivity. She underwent multiple cycles of chemotherapy, which produced some improvement, but she died as a consequence of pulmonary and hepatic complications 4 months after the initial diagnosis. Besides the process of diagnosing and typing a malignant lymphoma, this article outlines the value of computed tomography and the necessity of performing HTVL-1 investigation in patients with a diagnosis of lymphoma of T-cell lineage.

The carcinogenic potential of cadmium in the palatal and gingival epithelium of rats: a morphologic and morphometric analysis

Cádmio (Cd) é um metal pesado que exerce uma variedade de efeitos tóxicos, crônicos e agudos, em organismos expostos. O objetivo deste estudo foi investigar o potencial carcinogênico do Cd no epitélio do palato e da gengiva de ratos Wistar. Dois grupos de animais foram estudados: grupo 1 que consistiu de 5 ratos expostos a cloreto de cádmio (CdCl2) em água de bebedouro (300 mg/L) por um período de 6 meses; grupo 2 que também consistiu de 5 ratos submetidos às mesmas condições dos animais do grupo 1, mas permaneceu livre de Cd por um período adicional de 6 meses. Dois outros grupos (C1 and C2) com o mesmo número de animais, entretanto não expostos ao CdCl2, foram usados como controle para o grupo 1 e 2, respectivamente. Todos os animais foram pesados antes e após o período experimental. Após terem sido sacrificados, os tecidos de interesse para o estudo foram fixados em formalina a 10 por cento, processados por meio de técnica histopatológica padrão, corados em HE, e analisados sob microscopia de luz, utilizando parâmetros cariométricos e estereológicos. Perda de peso, atrofia do epitélio da gengiva e do palato mole foram os principais achados deste estudo, e verificados apenas no grupo 1 (p < 0.05). Em conclusão, Cd não produziu efeito carcinogênico nos tecidos orais, nas condições experimentais empregadas neste estudo.