A retrospective multicenter study of oral and maxillofacial lesions in older people.

Few studies on the distribution of oral diseases in older people are available in the literature. This study aimed to investigate the prevalence and demographic characteristics of oral and maxillofacial lesions in geriatric patients (age ≥ 60 years). A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from archives of three Brazilian oral pathology centers over a 20-year period. Data on sex, age, anatomical site, skin color, and histopathological diagnosis were collected and analyzed. Pearson's chi-square test was used to evaluate differences in the frequency of the different oral and maxillofacial lesion groups. A total of 7,476 biopsy records of older patients were analyzed. Most cases were diagnosed in patients aged 60 to 69 years (n = 4,487; 60.0%). Females were more affected (n = 4,403; 58.9%) with a female-to-male ratio of 1:0.7 (p < 0.001). The tongue (n = 1,196; 16.4%), lower lip (n = 1,005; 13.8%), and buccal mucosa (n = 997; 13.7%) were the most common anatomical sites. Reactive and inflammatory lesions (n = 3,840; 51.3%) were the most prevalent non-neoplastic pathologies (p < 0.001), followed by cysts (n = 475; 6.4%). Malignant neoplasms were more frequent (n = 1,353; 18.1%) than benign neoplasms (n = 512; 6.8%). Fibrous/fibroepithelial hyperplasia (n = 2,042; 53.2%) (p < 0.001) and squamous cell carcinoma (n = 1,191; 88.03%) (p < 0.001) were the most common oral lesions in older adults. Biopsy data allow the accurate characterization of the prevalence of oral and maxillofacial lesions, supporting the development of public health policies that can enable the prevention, early diagnosis, and appropriate treatment of these lesions. Also, they bring valuable information that helps dentists and geriatricians diagnose these diseases.

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study.

Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

Oral solitary fibrous tumors: A collaborative clinicopathologic study of 19 cases.

OBJECTIVE: To report the clinicopathologic features of 19 oral solitary fibrous tumors (SFTs). METHODS: Clinical data were collected from the records of seven pathology services. All cases were re-evaluated by HE staining and confirmed by immunohistochemistry. RESULTS: The series comprised 11 females (57.9%) and 8 males (42.1%), with a mean age of 47.3 ± 14.7 years (range: 22-71 years) and a 1.3:1 female-to-male ratio. Most tumors affected the buccal mucosa (n = 7; 36.8%) and presented clinically as an asymptomatic solitary submucosal well-circumscribed nodule with coloration similar to the oral mucosa. Morphologically, most SFTs (n = 10; 52.6%) exhibited a classic hybrid pattern characterized by a well-circumscribed proliferation of densely cellular areas alternating with hypocellular areas in a variably collagenous vascular stroma. Remnants of accessory salivary glands were observed in two cases (n = 2; 10.5%). All tumors were positive for STAT6 and CD34 (n = 19; 100%). Outcome information was available from 6 patients (31.6%), with clinical follow-up ranging from 6 to 24 months (mean ± SD, 9.5 ± 6.8 months), and none developed local recurrence. CONCLUSIONS: Oral SFTs are rare and often clinically misdiagnosed. Pathologists should consider SFT in the differential diagnosis of oral spindle cell tumors. Accurate diagnosis requires careful morphological evaluation supported by immunohistochemical analysis.

Gingival rhabdomyosarcoma mimicking a non-neoplastic proliferative lesion: A diagnostic challenge.

Rhabdomyosarcoma (RMS) is a soft tissue sarcoma that develops from skeletal striated muscle cells. RMSs are exceedingly rare in the oral cavity, particularly in the gingiva. Herein, we reported the clinicopathological and immunohistochemical features of a rare case of RMS in a 30-year-old female presenting clinically as a painful polypoid nodule on the mandibular gingiva. Microscopically, the tumor showed atypical spindle cells with elongated nuclei and eosinophilic cytoplasm arranged in a fascicular pattern. In focal areas, the tumor cells exhibited rhabdomyoblastic differentiation. Immunohistochemistry showed strong positivity for desmin, myogenin (scattered cells), and MyoD1. The patient underwent surgical resection followed by postoperative complementary radio- and chemotherapy. However, the patient had a local recurrence seven months after the initial treatment. She was submitted to a total mandibulectomy associated with adjuvant radiotherapy. However, she died two months after reoperation due to complications secondary to radiation therapy. Because of the rarity in the oral cavity and non-specific signs and symptoms, the clinical diagnosis of RMS is difficult and often overlooked. Therefore, careful histopathological and immunohistochemistry analysis of these tumors is essential to correct diagnosis. Early surgical excision with tumor-free margins and prolonged follow-up are strongly recommended.

A retrospective multicenter study of oral and maxillofacial lesions in older people

Abstract Few studies on the distribution of oral diseases in older people are available in the literature. This study aimed to investigate the prevalence and demographic characteristics of oral and maxillofacial lesions in geriatric patients (age ≥ 60 years). A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from archives of three Brazilian oral pathology centers over a 20-year period. Data on sex, age, anatomical site, skin color, and histopathological diagnosis were collected and analyzed. Pearson's chi-square test was used to evaluate differences in the frequency of the different oral and maxillofacial lesion groups. A total of 7,476 biopsy records of older patients were analyzed. Most cases were diagnosed in patients aged 60 to 69 years (n = 4,487; 60.0%). Females were more affected (n = 4,403; 58.9%) with a female-to-male ratio of 1:0.7 (p < 0.001). The tongue (n = 1,196; 16.4%), lower lip (n = 1,005; 13.8%), and buccal mucosa (n = 997; 13.7%) were the most common anatomical sites. Reactive and inflammatory lesions (n = 3,840; 51.3%) were the most prevalent non-neoplastic pathologies (p < 0.001), followed by cysts (n = 475; 6.4%). Malignant neoplasms were more frequent (n = 1,353; 18.1%) than benign neoplasms (n = 512; 6.8%). Fibrous/fibroepithelial hyperplasia (n = 2,042; 53.2%) (p < 0.001) and squamous cell carcinoma (n = 1,191; 88.03%) (p < 0.001) were the most common oral lesions in older adults. Biopsy data allow the accurate characterization of the prevalence of oral and maxillofacial lesions, supporting the development of public health policies that can enable the prevention, early diagnosis, and appropriate treatment of these lesions. Also, they bring valuable information that helps dentists and geriatricians diagnose these diseases.

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study

Abstract Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

Peripheral ossifying fibroma: A 20-year retrospective studywith focus on clinical and morphological features

Background: Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in thegingiva and is characterized by the deposition of dystrophic calcification, cementum-like tissue, and immatureand mature bone within the connective tissue. The objective of the present study was to perform a retrospectiveanalysis of clinicopathologic features of POF.Material and Methods: Clinical and histopathological data were obtained from biopsy records and histopathological reports from a Brazilian reference service in Oral Pathology (1999 - 2020). Morphological analysis wasperformed to evaluate features related to the mesenchymal component, inflammatory infiltrate, ulceration, andmineralized tissue.Results: A total of 270 POFs were diagnosed during the study period. A higher frequency was observed in females(71.9%) between the third (22.9%) and fourth (23.3%) decades of life. The anterior upper gingiva (29.1%) wasthe most affected region. Mature (86.7%) and immature (52.6%) bone tissue were the most frequent. There was asignificant association between immature bone deposition and lesions with size ≤ 1.7 cm (p = 0.041); immaturebone and cement-like tissue deposition with an evolution time ≤ 16 months (p < 0.001); deposition of immaturebone and mesenchymal hypercellularization (p < 0.001); deposition of dystrophic calcification and the presenceof ulceration (p < 0.001).Conclusions: The clinical characteristics corroborate the findings in the literature. The heterogeneous distributionand quantity of mineralized tissues found in the analyzed cases support the theory that the different mineralizedtissues constitute a spectrum of clinical maturation of POF. (AU)

Peripheral ossifying fibroma on the mandible: report of atypical presentation case / Fibroma ossificante periférico na mandíbula: relato de caso atípico

ABSTRACT Peripheral ossifying fibroma (POF) is a benign lesion, nodular, firm on palpation; the base is sessile or pedunculated; similar in color to the mucosa and epithelium; it may be preserved or ulcerated. It is prevalent in female and exclusively affects the gingiva. It is usually associated with irritating factors such as caries, dental plaque, among others. The objective of the present study is to report the case of a 27-years-old female patient, presenting a lesion in the mandible, complaining of an increased volume. Surgical excision was the treatment of choice. The patient is 24 months postoperatively with no signs of relapse.

RESUMEN El fibroma osificante periférico es una lesión benigna, nodular, firme a la palpación, de base sésil o pediculada, de color similar a la mucosa y al epitelio; puede estar intacto o ulcerado. Se observa más en mujeres y acomete solamente la encía. La lesión se asocia a factores irritantes, como caries, cálculo dental, entre otros. El objetivo del presente estudio es reportar el caso de una paciente de 27 años de edad, que ha presentado lesión en la mandíbula, quejando-se de aumento de volumen. La escisión quirúrgica ha sido el tratamiento de elección. La paciente encuentra se con 24 meses de postoperatorio, sin señales de recidva.

RESUMO O fibroma ossificante periférico (FOP) é uma lesão benigna, nodular, firme à palpação, de base séssil ou pediculada, com coloração semelhante à mucosa e ao epitélio; pode estar íntegro ou ulcerado. Prevalece no gênero feminino e acomete exclusivamente a gengiva. Associa-se a fatores irritantes, como cárie, cálculo dentário, entre outros. O objetivo do presente estudo é relatar o caso de uma paciente de 27 anos de idade, que apresentou lesão em mandíbula, queixando-se de aumento de volume. A excisão cirúrgica foi o tratamento de escolha. A paciente encontra-se com 24 meses de pós-operatório, sem sinais de recidiva.

Oral cavity lipoma: a study of 101 cases in a Brazilian population / Lipoma de cavidade oral: um estudo de 101 casos em uma população brasileira

ABSTRACT Introduction: Lipomas are benign soft tissue tumors commonly found in the human body. Although common in the head and neck region, in the oral cavity region they are uncommon, accounting for only 1% to 4% of benign oral cavity lesions. Objective: This study aims to identify the clinical and histopathological characteristics of oral cavity lipomas subjected to histopathological analysis at a pathology laboratory in the city of Fortaleza, Ceará, Brazil. Methods: Data from all cases of oral lesions diagnosed as lipoma and confirmed by histopathological examination over a period of 10 years were collected, including: gender, age, anatomical location, clinical diagnosis and histopathological subtypes. Results: During the period evaluated, 101 cases were diagnosed as lipomas, representing 1.01% of oral cavity biopsies. Females were more affected, with a male/female ratio of 1: 1.8, and with a peak of incidence between 50 and 70 years of age. The buccal mucosa was the most affected anatomical region, followed by the lower lip. Classic lipoma and fibrolipoma were the histological variants of lipoma most commonly found in the oral cavity, with 64 cases of classic lipoma and 29 cases of fibrolipoma. Other histological variants were: sialolipoma, angiolipoma, chondrolipoma, myxolipoma and intramuscular lipoma. Conclusion: Lipomas are uncommon lesions in the oral cavity, which present a higher prevalence in the buccal mucosa of adults, aged between 50 and 70 years, and with higher female preference.

RESUMEN Introducción: Lipomas son tumores benignos del tejido blando comúnmente encontrados en el cuerpo humano. Aunque comunes en la región de la cabeza y cuello, son raros en la cavidad oral, representando solo del 1% al 4% de las lesiones benignas en esa cavidad. Objetivo: El presente estudio pretende identificar las características clínicas e histopatológicas de lipomas de la cavidad oral; los materiales recolectados fueron analizados en un laboratorio de patología de la ciudad de Fortaleza, Ceará, Brasil. Métodos: Datos relativos a los últimos 10 años, como género, edad, localización anatómica, diagnóstico clínico y subtipos histopatológicos, se recolectaron de todos los casos de lesiones orales con el diagnóstico de lipoma confirmado mediante exámenes histopatológicos. Resultados: A lo largo del período evaluado, 101 casos fueron diagnosticados como lipomas, representando el 1,01% de las biopsias de la cavidad oral. El sexo femenino fue lo más afectado, con proporción hombre/mujer de 1:1,8, y pico de incidencia entre 50 y 70 años de vida. La mucosa yugal fue la región anatómica más afectada, seguida del labio inferior. Lipoma clásico y fibrolipoma fueron las variantes histológicas de lipoma más encontradas en la cavidad oral, con 64 casos de lipoma clásico y 29 de fibrolipoma. Otras variantes histológicas encontradas fueron sialolipoma, angiolipoma, condrolipoma, mixolipoma y lipoma intramuscular. Conclusión: Los lipomas son lesiones poco frecuentes en la cavidad oral y presentan mayor prevalencia en mucosa yugal de adultos con edades entre los 50 y los 70 años de vida, además de manifestaren preferencia por el sexo femenino.

RESUMO Introdução: Lipomas são tumores benignos de tecido mole comumente encontrados no corpo humano. Embora comuns na região de cabeça e pescoço, são raros na região da cavidade oral, representando apenas 1% a 4% das lesões benignas manifestadas nessa cavidade. Objetivo: O presente trabalho tem como objetivo identificar as características clínicas e histopatológicas de lipomas de cavidade oral; os materiais coletados foram submetidos a análise histopatológica em um laboratório de patologia da cidade de Fortaleza, Ceará, Brasil. Métodos: Dados referentes aos últimos 10 anos, como gênero, idade, localização anatômica, diagnóstico clínico e subtipos histopatológicos, foram coletados de todos os casos de lesões orais diagnosticados como lipoma e confirmados através de exames histopatológicos. Resultados: Durante o período avaliado, 101 casos foram diagnosticados como lipomas, representando 1,01% das biópsias de cavidade oral. O sexo feminino foi o mais acometido, com proporção homem/mulher de 1:1,8, e pico de incidência entre 50 e 70 anos de vida. A mucosa jugal foi a região anatômica mais afetada, seguida do lábio inferior. Lipoma clássico e fibrolipoma foram as variantes histológicas de lipoma mais encontradas na cavidade oral, com 64 casos de lipoma clássico e 29 de fibrolipoma. Outras variantes histológicas encontradas foram sialolipoma, angiolipoma, condrolipoma, mixolipoma e lipoma intramuscular. Conclusão: Os lipomas são lesões incomuns em cavidade oral e apresentam maior prevalência em mucosa jugal de adultos, com idades entre 50 e 70 anos, além de manifestarem predileção pelo sexo feminino.

Immunoexpression of calcitonin and glucocorticoid receptors in central giant cell lesions of the jaws.

BACKGROUND: This study analyzed the immunoexpression of calcitonin receptor (CTR) and glucocorticoid receptor (GR) in central giant cell lesions (CGCLs) and verified potential associations with patient's response to clinical treatment with intralesional injection of triamcinolone. MATERIALS AND METHODS: Fifty-four cases of CGCLs, including 22 non-aggressive, and 32 aggressive, were investigated by immunohistochemistry. RESULTS: Surgery was the therapeutic choice for 53.1% of the aggressive CGCLs, and 46.9% were submitted to the conservative treatment with intralesional triamcinolone injections. Among patients submitted to conservative treatment, 60% (n = 9) showed favorable response. CTR expression was observed in 68.51%, and GR in 94.44% of the total sample. There were no differences in the expression of CTR, neither GR in mononucleated stromal cells (MSCs) or multinucleated giant cells (MGCs), in relation to aggressiveness, treatment performed for and the response to conservative treatment. Both markers showed a positive correlation between their expression in MSCs and MGCs in the total sample (P < 0.0001). CTR expression on MSCs showed a positive correlation with MGCs in the aggressive and non-aggressive groups (P < 0.0001). CONCLUSIONS: Calcitonin receptor and GR expression were diffuse and similar in non-aggressive and aggressive cases, and it did not influence the response to clinical treatment with triamcinolone in the sample studied.

Aumento gengival associado à terapia de reposição hormonal / Gingival overgrowth associated to hormone replacement therapy ­ case report

Os aumentos gengivais são lesões proliferativas de evolução lenta e indolor que acometem os tecidos gengivais e envolvem várias possibilidades diagnósticas. O presente trabalho teve como objetivo relatar um caso clínico de aumento gengival em uma paciente jovem sob tratamento de reposição hormonal, ressaltando os aspectos clínicos e histopatológicos desta inter-relação.

Gingival overgrowth are proliferative lesions of painless and slow evolutive character, wich envolve the gingival tissues. This paper shows a case report of this lesion in a young female patient under hormone replacement therapy, highlightening the clinical and histopathologic aspects of this relationship.

The relative frequency of odontogenic tumors: A study of 376 cases in a Brazilian population

BACKGROUND: Odontogenic tumors (OTs) are rare lesions, exclusive of the jaws, that are derived from epithelial and/or ectomesenchymal elements of the tooth-forming apparatus. Their biological behavior is heterogeneous, including hamartomatous tissue proliferation, benign nonaggressive and aggressive neoplasms, and malignant tumors with metastatic capacity. The aim of this study was to describe the relative frequency of odontogenic tumors in a Brazilian population. In addition, a review of the literature identified studies on odontogenic tumors that follow the 2005 World Health Organization. MATERIAL AND METHODS: A total of 376 cases of odontogenic tumors from an oral pathology service were reviewed about age, gender, anatomic site and histologic diagnosis. RESULTS: Keratocystic odontogenic tumors (31.6%) were the most common, followed by ameloblastoma (28.5%), and odontoma (22.6%). The mean age was 32.2 years, and more than half the patients (52.1%) were in the second and third decades of life. The male to female ratio was 1:1.37, with a maxilla to mandible ratio of 1:2.08. CONCLUSIONS: The variation in relative frequency of tumors observed among the several series, including the present study, is probably due in part to cultural differences between geographic areas but also to the study design

Fibroma ossificante periférico ­ Relato longitudinal de dois casos clínicos / Long-term follow-up of peripheral ossifying fibroma ­ report of two cases

O fibroma ossificante periférico é uma lesão não neoplásica proliferativa, não patognomônico, de evolução lenta e indolor, que acomete os tecidos gengivais. O presente trabalho teve como objetivo relatar dois casos clínicos desta lesão em um acompanhamento em longo prazo, ressaltando os aspectos clínicos e histopatológicos, bem como seu tratamento e prognóstico.

The peripheral ossifying fibroma is a non-neoplasic, proliferative lesion of painless and slow evolutive character, which involves the gingival tissues. This paper reports on two clinical cases in a long-term follow-up highlightening their clinical and histopathologic aspects, treatment, and outcomes.

Clear cell variant of calcifying epithelial odontogenic tumor: Case report with immunohistochemical findings.

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm, locally aggressive, characterized by sheets and nests of polyhedral epithelial cells exhibiting eosinophilic cytoplasm or less often clear cytoplasm. Additional features include nuclear pleomorphism without mitotic activity, concentric calcifications, and deposits of amyloid. Herein, we present an additional example of clear cell variant of CEOT occurring in a 25-year-old female. Microscopically, the tumor consisted on proliferation of epithelial cells with eosinophilic, clear vacuolated cytoplasm interspersed with focal areas of amyloid deposition. Tumor cells were immunopositive for AE1/AE3, CK14, CK19, ß-catenin, CD138, and p63. Key words:Calcifying epithelial odontogenic tumor, clear cell, histopathology, immunohistochemistry.

Perfil Epidemiológico de 23 casos de neoplasias malignas da cavidade oral atendidos em uma instituição odontológica de nível secundário / Epidemiological profile of 23 cases of malignant neoplasm of the oral cavity treated in a secondary dentistry institution

Introdução: O Câncer Bucal representa atualmente um dosgraves problemas de saúde pública no Brasil. Conforme dados doInstituto Nacional do Câncer (INCA), para o ano de 2012, estimase14.170 novos casos. Objetivo: Avaliar o perfil epidemiológicode 23 pacientes portadores de neoplasias malignas atendidos emuma instituição odontológica de atenção secundária no períodoentre maio de 2007 e setembro de 2009. Método: Prontuáriosde 23 pacientes com resultado histopatológico de lesão malignada cavidade oral foral revisados. Gênero, idade, sítio anatômicoe associação com tabagismo e etilismo foram avaliados.Resultados: O carcinoma espinocelular foi o mais prevalente,correspondendo a 87% dos casos. Houve maior prevalência nogênero masculino (60,9%) e na faixa etária entre 50 e 60 anos.Os sítios anatômicos mais acometidos foram língua (34,8%) eassoalho bucal (21,7%). Verificou-se uma associação entre aocorrência das lesões malignas e o hábito de tabagismo umavez que, do total de pacientes acometidos, 47,8% eram fumantese 43,5% eram ex-fumantes. O perfil epidemiológico encontradocondiz com os achados de estudos anteriormente realizados.Conclusões: A caracterização dos casos de câncer bucalpermite definir o perfil epidemiológico dos pacientes acometidose possivelmente represente grande contribuição para oestabelecimento de políticas preventivas relacionadas à doença.

Extensive thyroglossal duct cyst in 83-year-old patient.

Thyroglossal duct cysts (TDCs) are developmental cysts that occur in the neck. These lesions are usually encountered in the first decade of life; cases appear to be rare in elderly patients. Thirteen cases have been reported so far in patients over 70 years of age. Although the Sistrunk procedure remains the standard treatment, the management of TDCs continues to be a matter of controversy in some instances. We report the third case of extensive TDC published in patients over 80 years of age.

Uso de azitromicina no tratamento de abscesso periodontal em paciente diabético descompensado / The use of azithromycin in the treatment of periodontal abscess in a poorly controlled diabetic patient. Case report

O objetivo do presente trabalho foi relatar um caso clínico de uma paciente diabética descompensada portadora de abscesso periodontal. O tratamento foi realizado por meio de drenagem, raspagem subgengival, irrigação com iodo-povidine e prescrição de azitromicina por três dias. O exame clínico e radiográfico após seis meses demonstrou remissão do quadro clínico e estabilidade dos tecidos periodontais. Desta forma, a azitromicina associada ao tratamento local foi efetiva no tratamento de abscesso periodontal em paciente diabético descompensado.