Seroprevalence of HSV-1/2 and correlation with aggravation of oral mucositis in patients with squamous cell carcinoma of the head and neck region submitted to antineoplastic treatment.

PURPOSE: Oral mucositis (OM) is a frequent side effect resulting from antineoplastic treatment and is described as an acute alteration characterized by ulcerative lesions, with the presence of a persistent chronic inflammatory infiltrate, erythema, and pain. AIMS: The purpose of the study was to evaluate the presence of the herpes simplex virus (HSV-1/2) in patients with squamous cell carcinoma of the head and neck region (SCC) and its influence on the aggravation of oral mucositis after radiotherapy or radio/chemotherapy treatment. METHODS: In this prospective cohort study, 91 patients were evaluated with regard to their serological status for IgG before treatment (initial time interval--TI) and for IgM before treatment (T1) and on the 30th day after the first day of radiotherapy application/radiation therapy (final time interval--TF), using immunoenzymatic assay (ELISA), and the results were correlated with the intensity of OM. RESULTS: The seroprevalence for IgG was 97.8 %. IgM (TI) was positive in 18.7% and IgM (TF) in 20.9% of patients. All the patients developed some degree of oral mucositis; however, there was statistically significant correlation between positivity for IgM and degree of severity of OM, irrespective of the type of treatment to which the patient was submitted. CONCLUSION: The reactivation of HSV-1/2 was shown to be relatively infrequent and there was no correlation between presence of the virus and aggravation of oral mucositis resulting from antineoplastic treatment.

Mandibular desmoplastic ameloblastoma: case report.

Desmoplastic ameloblastoma (DA) is a tumor characterized by unique clinical, radiological, and histopathologic features, mostly an abundance of densely collagenous stroma with small nests and islands of odontogenic epithelium. Due to its aggressive, highly invasive nature, there is a tendency to treat DA with bone resection. This article reports and discusses an uncommon case of mandibular DA, focusing on the importance of early, effective treatment.

Ameloblastic fibroma: A rare case appearing as a mixed radiographic image.

Ameloblastic fibroma (AF) is a benign tumor of mixed odontogenic origin, which affects predominantly young individuals. AF appearing as a mixed radiographic image is very rare. This report describes a case of AF in a 12-year-old male identified during a routine radiographic exam for orthodontic treatment planning. The panoramic radiography revealed a well-defined multilocular mixed image located in the mandible between the roots of the left mandibular second premolar and first molar. The lesion was excised under local anesthesia. Histopathological analysis revealed islands of epithelial cells and columnar peripheral cells showing a nucleus in inverted polarization, interspersed with spindle-shaped cells and abundant extracellular matrix deposition. No atypia was observed. The diagnosis of AF was established. No tumor recurred up to 30 months after treatment. Although rare, AF should be also considered in the differential diagnosis of mixed radiographic images of the jaws in young patients. Key words:Ameloblastic fibroma, differential diagnosis, incidental finding, mixed image, radiographic features.

Low-level laser in prevention and treatment of oral mucositis in pediatric patients with acute lymphoblastic leukemia.

OBJECTIVE: The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) on the prevention and treatment of oral mucositis (OM) in pediatric cancer patients taking methotrexate. BACKGROUND DATA: OM is a very common, potentially severe side effect, caused by treatment with radiotherapy and chemotherapy for cancer. METHODS: Forty patients with acute lymphoblastic leukemia, who received high doses of methotrexate, were distributed into two groups. Group A (Preventive Group) was composed of patients who received preventive laser (red-subgroup A1 or infrared-subgroup A2) for 5 days, beginning on the 1st day of infusion. Group B (Treatment Group) was composed of patients who received laser treatment only if they developed post-chemotherapy mucositis (red-subgroup B1 or infrared-subgroup B2). Laser was used at wavelengths of 660 or 830 nm with output 100 mW, power density 3.57 W/cm(2), spot size 0.028 cm(2), energy of 1 J, resulting in an energy density of 35 J/cm(2) for 10 sec in the prophylactic group, and energy of 2 J, resulting in energy density of 70 J/cm(2) for 20 sec in the therapeutic group. RESULTS: The percentage of patients who did not develop OM was higher in Group A (60% vs. 25%). In Group B, 3/20 patients developed grade IV OM (15%), and a significant difference was found between the two subgroups at the end of treatment (p=0.019). CONCLUSIONS: Prophylactic laser produced a better outcome than when patients did not receive any preventive intervention, and red laser (660 nm) was better than infrared (830 nm) in the prevention and treatment of OM.