Windshield glass fragment mimicking a nasal fracture / Fragmento de parabrisas mimetizando fratura nasal / Fragmento de vidrio del parabrisas que imita una fractura nasal

A male patient with facial trauma by road traffic accident arrived in the emergency room and he was assisted by the Trauma and Neurosurgery team. After clinical evaluation a frontal sinus anterior wall fracture plus a nasal fracture were diagnosed. On the primary OMS examination was checked multiple facial lacerations and gross nasal dorsum deviation with pain, nasal airway obstruction and crepitus with clinical diagnosis of a nasal fracture. After radiologic exam a piece of windshield glass that was superimposed on the nasal bones simulating a nasal fracture was visualized. This paper presents clinical data and literature review of foreign body mimicking facial fractures(AU)

Paciente do sexo masculino com trauma facial por acidente de trânsito foi avaliado na sala de emergência e foi atendido pelas equipes de Trauma e Neurocirurgia. Após avaliação clínica, foi diagnosticada fratura da parede anterior do seio frontal e fratura nasal. No exame facial foram verificadas múltiplas lacerações faciais e desvio do dorso nasal com dor, obstrução das vias aéreas e crepitação com diagnóstico clínico de fratura nasal. Após o exame radiográfico visualizou-se fragmento de vidro do pára-brisa que estava sobreposto nos ossos nasais simulando fratura. Este artigo apresenta dados clínicos e revisão de literatura de corpo estranho, mimetizando fraturas faciais(AU)

Un paciente masculino con trauma facial por accidente de tráfico llegó a la sala de emergencia y fue asistido por el equipo de Trauma and Neurocirurgia. Después de la evaluación clínica, se diagnosticaron fracturas de la pared anterior del seno frontal más una fractura nasal. En el examen primario de OMS se verificaron múltiples laceraciones faciales y desviación neta del dorso nasal con dolor, obstrucción nasal de las vías aéreas y crepitación con diagnóstico clínico de fractura nasal. Después del examen radiológico, se visualizó un trozo de vidrio del parabrisas superpuesto a los huesos nasales que simulaba una fractura nasal. Este artículo presenta datos clínicos y revisión de la literatura de cuerpos extraños que imitan fracturas faciales(AU)

Fosfato tricálcico e hidróxido de cálcio no reparo ósseo em coelho. Estudo histológico e histomorfométrico / Tricalcium phosphate and calcium hydroxide in rabbit bone repair. Histological and histomorphometric evaluation

A deficiência óssea requer procedimentos restauradores como uso de enxertos e substitutos ósseos para a reabilitação estética e funcional. Com o desenvolvimento dos biomateriais, a biocerâmica à base de fosfato de cálcio tornou-se alternativa promissora para a recomposição de estruturas ósseas, entretanto não apresenta potencial de osteoindução. O material hidróxido de cálcio (Ca(OH)2) demonstra propriedades antibacterianas e capacidade de induzir a formação de tecido ósseo. O objetivo deste trabalho foi avaliar o processo de reparo ósseo proporcionado pelo BTCP e Ca(OH)2 , isolados e associados. Realizou-se experimento em tíbias posteriores de dezoito coelhos. Dois animais receberam marcadores ósseos para fluorescência (alizarina, calceína e tetraciclina), e para cada tíbia foi utilizado um tipo de material de preenchimento (BTCP, Ca(OH)2, BTCP com Ca(OH)2 e sangue como controle); sendo eutanasiados após 56 dias para a análise de fluorescência e histomorfometria. Os 16 coelhos restantes foram aleatoriamente selecionados para receber os quatro materiais de preenchimento. Estes foram eutanasiados nos tempos de 14, 28, 42 e 56 dias para a análise morfológica microscópica com coloração em hematoxilina e eosina. Observou-se formação óssea em todos os grupos, e os que utilizaram BTCP apresentaram atraso para o início da reparação.

O sítio preenchido com sangue ocorreu apenas o reparo da estrutura lesada, consistindo na reconstituição da cortical óssea e tecido medular em 28 dias. Aos 56 dias, o grupo de BTCP com Ca(OH)2 apresentou maior formação de trabéculas no interior da tíbia. Na avaliação histomofométrica, o marcador calceína apresentou maiores valores de deposição óssea em relação à alizarina e tetraciclina. Conclui-se que os biomateriais BTCP e Ca(OH)2 estão diretamente envolvidos na formação de tecido ósseo no interior do defeito; a combinação do Ca(OH)2 com BTCP mostrou aumento do potencial de formação óssea; e houve maior deposição óssea no período entre quinta e sexta semana de reparação indicado pelo marcador calceína.

Insufficient bone volume requires restorative procedures such as use of grafts and bone substitutes for cosmetic and functional rehabilitation. The development of biomaterials made available bioceramic based on calcium phosphate that is showing to be promising alternatives for the restoration of bony structures, however it do not has osteoinductive potential. Calcium hydroxide (Ca(OH)2) shows antibacterial properties and induce bone tissue formation as well. The objective of this research was to evaluate the bone healing process promoted by BTCP and Ca(OH)2 isolated or conjugated. The experiment was conducted in posterior rabbit tibiae of 18 animais. Two animais received bone markers (alizarin, calcein, tetracycline) and each of their tibias received a type offiller material (BTCP, Ca(OH)2, BTCP plus Ca(OH)2 and blood as control group), being euthanized after 56 days for the histomorphometry and fluorescence analysis. The remaining 16 rabbits were randomly selected to receive one of the 4 filling materiais. These rabbits were euthanized on 14,28,42 and 56 days for the micromorphological analysis in hematoxylin and eosin slides. The bone formation was observed in ali groups, and who used BTCP had delay to the start of repair. The site filled with blood occurred only repair of the damaged structure, consisting of the reconstitution of the bone cortical and medullary tissue in 28 days. After 56 days, the BTCP group with Ca(OH)2 showed higher trabecular formation inside the tibia. In histomorfometric evaluation, the marker calcein had higher bone deposition values in relation to alizarin and tetracycline. It was concluded that the biomaterials BTCP and Ca(OH)2 are directly involved in the formation of bone tissue; the conjugation of Ca(OH)2 with BTCP increased bone formation potential; and there was greater bone deposition in the period between the fifth and sixth week of repairs indicated by calcein marker.

Fosfato tricálcico e hidróxido de cálcio no reparo ósseo em coelho. Estudo histológico e histomorfométrico / Tricalcium phosphate and calcium hydroxide in rabbit bone repair. Histological and histomorphometric evaluation

A deficiência óssea requer procedimentos restauradores como uso de enxertos e substitutos ósseos para a reabilitação estética e funcional. Com o desenvolvimento dos biomateriais, a biocerâmica à base de fosfato de cálcio tornou-se alternativa promissora para a recomposição de estruturas ósseas, entretanto não apresenta potencial de osteoindução. O material hidróxido de cálcio (Ca(OH)2) demonstra propriedades antibacterianas e capacidade de induzir a formação de tecido ósseo. O objetivo deste trabalho foi avaliar o processo de reparo ósseo proporcionado pelo BTCP e Ca(OH)2 , isolados e associados. Realizou-se experimento em tíbias posteriores de dezoito coelhos. Dois animais receberam marcadores ósseos para fluorescência (alizarina, calceína e tetraciclina), e para cada tíbia foi utilizado um tipo de material de preenchimento (BTCP, Ca(OH)2, BTCP com Ca(OH)2 e sangue como controle); sendo eutanasiados após 56 dias para a análise de fluorescência e histomorfometria. Os 16 coelhos restantes foram aleatoriamente selecionados para receber os quatro materiais de preenchimento. Estes foram eutanasiados nos tempos de 14, 28, 42 e 56 dias para a análise morfológica microscópica com coloração em hematoxilina e eosina. Observou-se formação óssea em todos os grupos, e os que utilizaram BTCP apresentaram atraso para o início da reparação. O sítio preenchido com sangue ocorreu apenas o reparo da estrutura lesada, consistindo na reconstituição da cortical óssea e tecido medular em 28 dias. Aos 56 dias, o grupo de BTCP com Ca(OH)2 apresentou maior formação de trabéculas no interior da tíbia. Na avaliação histomofométrica, o marcador calceína apresentou maiores valores de deposição óssea em relação à alizarina e tetraciclina. Conclui-se que os biomateriais BTCP e Ca(OH)2 estão diretamente envolvidos na formação de tecido ósseo no interior do defeito; a combinação do Ca(OH)2 com BTCP mostrou aumento do potencial de formação óssea; e houve maior deposição óssea no período entre quinta e sexta semana de reparação indicado pelo marcador calceína.

Insufficient bone volume requires restorative procedures such as use of grafts and bone substitutes for cosmetic and functional rehabilitation. The development of biomaterials made available bioceramic based on calcium phosphate that is showing to be promising alternatives for the restoration of bony structures, however it do not has osteoinductive potential. Calcium hydroxide (Ca(OH)2) shows antibacterial properties and induce bone tissue formation as well. The objective of this research was to evaluate the bone healing process promoted by BTCP and Ca(OH)2 isolated or conjugated. The experiment was conducted in posterior rabbit tibiae of 18 animais. Two animais received bone markers (alizarin, calcein, tetracycline) and each of their tibias received a type offiller material (BTCP, Ca(OH)2, BTCP plus Ca(OH)2 and blood as control group), being euthanized after 56 days for the histomorphometry and fluorescence analysis. The remaining 16 rabbits were randomly selected to receive one of the 4 filling materiais. These rabbits were euthanized on 14,28,42 and 56 days for the micromorphological analysis in hematoxylin and eosin slides. The bone formation was observed in ali groups, and who used BTCP had delay to the start of repair. The site filled with blood occurred only repair of the damaged structure, consisting of the reconstitution of the bone cortical and medullary tissue in 28 days. After 56 days, the BTCP group with Ca(OH)2 showed higher trabecular formation inside the tibia. In histomorfometric evaluation, the marker calcein had higher bone deposition values in relation to alizarin and tetracycline. It was concluded that the biomaterials BTCP and Ca(OH)2 are directly involved in the formation of bone tissue; the conjugation of Ca(OH)2 with BTCP increased bone formation potential; and there was greater bone deposition in the period between the fifth and sixth week of repairs indicated by calcein marker.

Melanotic neuroectodermal tumor of infancy in the maxilla.

Melanotic neuroectodermal tumors of infancy (MNTIs) are rare fast-growing tumors with high recurrence rates. These tumors, which originate in the neural crest, commonly occur in the anterior maxilla of children under the age of one. Here, we describe an MNTI case in a two-month-old girl with increasing swelling in the left cheek. MNTI was diagnosed in this case following tomography and biopsy. The patient's histological and immunohistochemical profile indicated a remarkable combination of neural, melanocytic, and epithelial cell differentiation. One year following tumor excision, a follow-up examination revealed that the child exhibited no tumor recurrence. Approximately 260 cases of MNTI have been reported since this type of tumor was first described. In the present case, early diagnosis minimized the difficulties and risks associated with treatment and facilitated an optimal outcome. Despite complete surgical excision, careful followup is recommended. In addition, maxillary functional orthopedics and reconstruction may be necessary in cases of MNTI.

Ultrasound-guided needle aspiration of parotid abscess.

Ultrasound (US) has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.

Oral mucocele of unusual size on the buccal mucosa: clinical presentation and surgical approach.

Oral mucoceles are small-size, benign minor salivary gland pathologies. The most frequent localizations of these lesions are the lower lip mucosa. However, in some cases, they grow to an unusual size and hinder the preliminary diagnosis of mucocele. The purpose of this article is to report a case of a large oral mucocele with a diameter of 3.5 cm on the buccal mucosa of a 43-years-old male patient. The surgical procedure was carried out for a complete removal of the lesion.

Lichenoid reaction to carbamazepine in the oral mucosa: case report.

Lichenoid drug reactions are more common in skin, but they may also occur in the oral mucosa. It is difficult to diagnose these lesions due to their clinical similarity to the idiopathic oral lichen planus lesions. The present article reports a case of lichenoid reaction in oral mucosa associated to the use of carbamazepine, emphasizing the diagnostic process.

Analysis of a possible association between oral lichen planus anddrug intake. A controlled study

Objectives: To investigate whether daily systemic and/or topical medication contributes to the development of orallichen planus (OLP) lesions.Study Design: The study involved 110 OLP patients and 76 control subjects, matched by age, race and sex. Theanalyzed data included medical records, drug intake and topical medication. Criteria for analysis of drug intakeincluded: (1) ATC-code drug classification; (2) number of different drugs used daily in the categories of monopharmacy(1 drug), minor polypharmacy (2–4 drugs), and major polypharmacy (> 5 drugs); and (3) drugs implicatedin lichenoid reactions (DILRs).Results: Sixty (54.5%) of the 110 OLP patients reported daily medication (prior to the appearance of the OLPlesion) compared to 52 (68.4%) of the 76 control subjects. No statistical difference was found between the twogroups in terms of systemic diseases, number of medicated individuals in the categories of mono- and polypharmacy,nor use of DILRs (P > 0.05). Regarding the clinical forms and site of involvement, a statistically significantdifference was only found for the clinical erosive form of OLP, seen more frequently in non-DILR (P = 0.04) andnonmedicated OLP patients (P = 0.02) than in DILR OLP patients. Daily use of topical oral medication was reportedby 2 (1.8%) OLP patients and 1 (1.3%) control subject.Conclusions: It seems that the use of systemic medication does not lead to a significant increase in the incidence ofOLP lesions. For their part, lichenoid drug reactions are likely to occur only in a very low percentage of patients (AU)

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Reação liquenoide à carbamazepina em mucosa bucal: relato de caso / Lichenoid reaction to carbamazepine in the oral mucosa: case report

As reações liquenoides por drogas são mais comuns na pele, mas também podem ocorrer na mucosa bucal. Estas lesões são de difícil diagnóstico por causa de sua semelhança clínica com às do líquen plano oral idiopático. O presente artigo relata um caso de reação liquenoide em mucosa bucal, associado ao uso de carbamazepina, no qual o processo de diagnóstico é enfatizado.

Lichenoid drug reactions are more commom in skin, but they may also occur in the oral mucosa. It is difficult to diagnose these lesions due to their clinical similarity to the idiopathic oral lichen planus lesions. The present article reports a case of lichenoid reaction in oral mucosa associated to the use of carbamazepine, emphasizing the diagnostic process.

Analysis of a possible association between oral lichen planus and drug intake. A controlled study.

OBJECTIVES: To investigate whether daily systemic and/or topical medication contributes to the development of oral lichen planus (OLP) lesions. STUDY DESIGN: The study involved 110 OLP patients and 76 control subjects, matched by age, race and sex. The analyzed data included medical records, drug intake and topical medication. Criteria for analysis of drug intake included: (1) ATC-code drug classification; (2) number of different drugs used daily in the categories of monopharmacy (1 drug), minor polypharmacy (2-4 drugs), and major polypharmacy ( > 5 drugs); and (3) drugs implicated in lichenoid reactions (DILRs). RESULTS: Sixty (54.5%) of the 110 OLP patients reported daily medication (prior to the appearance of the OLP lesion) compared to 52 (68.4%) of the 76 control subjects. No statistical difference was found between the two groups in terms of systemic diseases, number of medicated individuals in the categories of mono- and polypharmacy, nor use of DILRs (P > 0.05). Regarding the clinical forms and site of involvement, a statistically significant difference was only found for the clinical erosive form of OLP, seen more frequently in non-DILR (P = 0.04) and nonmedicated OLP patients (P = 0.02) than in DILR OLP patients. Daily use of topical oral medication was reported by 2 (1.8%) OLP patients and 1 (1.3%) control subject. CONCLUSIONS: It seems that the use of systemic medication does not lead to a significant increase in the incidence of OLP lesions. For their part, lichenoid drug reactions are likely to occur only in a very low percentage of patients.

Use of retinoids in the treatment of oral leukoplakia: a review / Uso de retinoides no tratamento de leucoplasias bucais: revisão

OBJECTIVE: The purpose of this paper is to review the literature regarding the topical use of the retinoids in the treatment of oral leukoplakia, discussing their mechanisms of action, indications, effectiveness, and adverse effects. DISCUSSION: Leukoplakia is defined as white lesion in oral mucous membrane that cannot be characterized as any other entity and it has potential for malignancy. It does not present specific histological pattern. Due to its potential for malignancy and high prevalence, dentists should know how to diagnose and treat it correctly. The retinoids are chemopreventive agents derived from the vitamin A. They could be either natural or synthetic and their main role is to suppress cellular mitosis. Retinoid derivatives have been used as agents for chemoprevention of malignant transformation of leukoplakias due to its potential effect on the control of the differentiation and proliferation of the epithelial cells, as well as their induction of apoptosis. CONCLUSION: The topical use of retinoids to treat oral leukoplakia is safe, convenient and effective, with minor side effects than the systemic administration.

OBJETIVO: A proposta deste artigo é revisar a literatura referente ao uso de retinoides no tratamento de lecoplasiasbucais e discutir o mecanismo de ação, indicações, efetividade e efeitos adversos. DISCUSSÃO: Leucoplasia é definida como lesão branca na mucosa bucal que não pode ser caracterizada como qualquer outra entidade e tem potencial de malignização. Não apresenta padrão histológico específico e, por causa de seu potencial de malignização e alta prevalência, os cirurgiões-dentistas devem conhecer como diagnosticá-la e tratá-la corretamente. Os retinoidestêm sido usados como agentes quimio-profiláticos para a transformação maligna das leucoplasias por seu efeito potencial no controle da diferenciação e proliferação da células epiteliais, bem como capazes de indução de apoptose. CONCLUSÃO: O uso tópico de retinoides para tratar leucoplasias é seguro, conveniente e efetivo, com efeitos colaterais menores do que na administração sistêmica.

Escleroterapia de hemangioma labial / Sclerotherapy of labial hemangioma

O hemangioma é um tumor benigno que se caracteriza por proliferação anormal de vasos sanguíneos. Acomete, na cavidade bucal, mais comumente a região de lábios, língua e mucosa jugal. Dentre as opções terapêuticas, a escleroterapia vem sendo utilizada com resultados satisfatórios clínicos e estéticos. O propósito deste trabalho é apresentar o caso de hemangioma labial em paciente do gênero feminino, tratado através de injeções de solução esclerosante de oleato de monoetanolamina com remissão total da lesão. Neste caso, foi possível promover a involução da lesão com segurança, através de procedimento não cirúrgico, favorecendo no pós-operatório, a estética da paciente.

Hemangioma is a benign tumor that characterized for abnormal proliferation of sanguineous vessels. It afectted the oral cavity, more commonly in the region of lips, tongue and bucal mucosa. Among the therapeutical options, the sclerotherapy was being used with clinical and aesthetic satisfactory results. The aim of this work is to present one case of lip hemangioma in female patient, treated through injections to sclerosing solution of monoethanolamine oleate with total remission of the lesion. In this case it was possible to promote the regression of the lesion with security, without surgical procedures, been less invasive and more favorable to aesthetic of the patient.