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Synchronous jawbone diseases: a multicenter retrospective study
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REZENDE, Diogo dos Santos da Mata

; SOUZA, Lucas Lacerda de

; UCHÔA, Daniel Cavalléro Colares

; FERNANDES, Lais Albuquerque

; LEMOS, Jeanne Gisele Rodrigues de

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ARBOLEDA, Lady Paola Aristizabal

; ROCHA, André Caroli

; GONÇALVES, Fábio Luiz Neves

; PONTES, Flávia Sirotheau Corrêa

; FONSECA, Felipe Paiva

; PONTES, Hélder Antônio Rebelo

Brazilian Oral Research

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2023, Volume 37 elocation e011

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study is to report an original case series of synchronous jawbone diseases. Data of patients seen over 13 years were extracted from the files of three Oral Radiology and Pathology diagnostic centers in Brazil. The clinical, radiographic, and laboratory characteristics were tabulated and analyzed by the authors; the patients were described according to lesion type. Seventy-two synchronous jawbone diseases were included in this study. Florid osseous dysplasia, Gorlin-Goltz syndrome, and cherubism were the most frequent disorders reported in this case series. In addition, the posterior mandible area was the main site of manifestation. Florid osseous dysplasia and Gorlin-Goltz syndrome represented two-thirds of our samples. With the utilization of adequate demographic, clinical, and radiologic information, it is possible to diagnose most of the synchronous lesions of jawbones. Sometimes, however, we need complementary exams, such as histopathologic and biochemical analysis or dosing of calcium, phosphorus, and alkaline phosphatase.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0011

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

A retrospective multicenter study of oral and maxillofacial lesions in older people
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CUNHA, John Lennon Silva

; CAVALCANTE, Israel Leal

; RODRIGUES, Ana Beatriz Rocha

; CATÃO, Niely Enetice de Sousa

; CRUZ, Vitória Maria Sousa

; TURATTI, Eveline

; CAVALCANTE, Roberta Barroso

; FONSECA, Felipe Paiva

; GORDÓN-NÚÑEZ, Manuel Antonio

; ALVES, Pollianna Muniz

; NONAKA, Cassiano Francisco Weege

; ANDRADE, Bruno Augusto Benevenuto de

Brazilian Oral Research

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2023, Volume 37 elocation e098

Resumo: En | Texto: En | PDF: En

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.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0098

Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
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Benites, Bernar Monteiro

; Miranda-Silva, Wanessa

; Rocha, André Caroli

; Passos, Ula Lindoso

; Fonseca, Felipe Paiva

; Silva, Celso Arrais Rodrigues da

; Fregnani, Eduardo Rodrigues

Autopsy and Case Reports

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2021, Volume 11 elocation e2020218

Resumo: En | Texto: En | PDF: En

ABSTRACT The Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve’s distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is related to the fact that it represents the clinical manifestations of malignant diseases. Breast cancer and non-Hodgkin lymphoma are the most common cause of NCS. The patient, a 58-year-old woman, treated for a Burkitt Lymphoma (BL) nine years ago, described a two-week history of change in sensitivity and pain in the chin region, without relief with the use of analgesics. She had no headache, speech disturbance, dysphagia, visual disturbance, or other neurological symptoms. No surgical intervention has been performed recently. The intraoral examination revealed a healthy oral mucosa and a small area adjacent to the right mental nerve region that was uncomfortable to palpation. No changes were found in the bone trabeculae at cone-beam computed tomography. The contrasted magnetic resonance features made it possible to identify a change in the mandibular body extending to the entire right side, coinciding with the patient’s complaint, indicating a probable mandibular medullary invasion. The patient was submitted to a biopsy to rule out a possible recurrence of BL. The microscopic findings were consistent with the diagnosis of BL. The present report described a very unusual presentation of late recurrent BL nine years after the first treatment, which manifested as an NCS.

https://doi.org/10.4322/acr.2020.218 372 downloads

Myeloid sarcoma in the tongue
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Benites, Bernar Monteiro

; Fonseca, Felipe Paiva

; Miranda-Silva, Wanessa

; Bruno, Julia Stephanie

; Tucunduva, Luciana

; Fregnani, Eduardo Rodrigues

Autopsy and Case Reports

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2020, Volume 10 Nº 2 elocation e2020160

Resumo: En | Texto: En | PDF: En

Abstract Leukemic cells are rarely present in the oral cavity, and there are very few reports regarding such cases. However, we identified some reports of leukemic cells infiltrating tissues in the oral cavity, including gingival involvement. Recurrent painful oral ulcerations and prominent generalized periodontal destruction are the most common oral features of neutrophil disorders, and they may even be the initial symptoms of the disease. The ulcers may affect any part of the oral mucosa, including the tongue and palate. The objective of this report is to describe and discuss a case of myeloid sarcoma in the oral cavity of a 48-year-old male patient.

https://doi.org/10.4322/acr.2020.160 430 downloads

Distribution of Dendritic Cells in AIDS-Associated Oral Kaposi’s Sarcoma
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Cáceres, Cinthia Veronica Bardalez Lopez de

; Vargas, Pablo Agustin

; Sánchez-Romero, Celeste

; Bunn, Belinda K

; Heerden, Willie F. P. van

; Fonseca, Felipe Paiva

Brazilian Dental Journal

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Nov 2019, Volume 30 Nº 6 Páginas 617 - 625

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste estudo foi determinar se a distribuição das células de Langerhans (CL) e das células dendríticas intersticiais (CDI) está alterada no sarcoma de Kaposi oral associado à AIDS quando comparado às lesões orais altamente vasculares HIV-negativas. 51 casos de sarcoma de Kaposi oral associado à AIDS e 20 de lesões orais altamente vasculares foram recuperados retrospectivamente. Todos os casos de sarcoma de Kaposi foram confirmados pela positividade para os anticorpos CD34 e HHV-8. Dados clínicos sobre sexo, idade e localização das lesões foram obtidos dos laudos histopatológicos. Foram realizadas imunoistoquímica contra CD207 (células dendríticas imaturas) e CD83 (células dendríticas maduras). As CL estavam presentes no epitélio enquanto as CDI estavam presentes no estroma. As células CD207+ predominaram no epitélio das lesões, enquanto as células CD83+ predominaram no estroma. O sarcoma de Kaposi teve uma contagem mais baixa de CD imaturas CD207+ (p = 0,02) e número aumentado de CDC CD207+ do que lesões orais altamente vasculares (p<0,001). Além disso, o sarcoma de Kaposi também mostrou um número aumentado de CDI CD83+ maduras do que lesões orais altamente vasculares (p<0,001). Houve alterações significativas na distribuição de CL e CDI no sarcoma de Kaposi associado à AIDS quando comparado às lesões orais vasculares HIV-negativas, sugerindo que alterações na distribuição das mesmas podem desempenhar um papel na patogênese do sarcoma de Kaposi.

Abstract The aim of this study was to determine if the distribution of Langerhans cells (LC) and interstitial dendritic cells (IDC) is altered in AIDS-associated oral Kaposi’s sarcoma when compared to HIV-negative highly vascular oral lesions. Fifty-one cases of AIDS-associated oral Kaposi’s sarcoma and 20 of highly vascular oral lesions were retrospectively retrieved. All cases of Kaposi’s sarcoma were confirmed with immunoreactions against CD34 and HHV-8. Clinical data regarding sex, age and lesions location were obtained from pathology reports. Immunohistochemistry against CD207 (immature dendritic cells) and CD83 (mature dendritic cells) were done. LC were in the epithelium and IDC in the stroma. CD207+ cells predominated in the epithelium of the lesions, whereas CD83+ cells predominated in their stromal compartment. Kaposi’s sarcoma had a lower CD207+ immature LC count (p=0.02) and an increased CD207+ IDC than highly vascular oral lesions (p<0.001). Moreover, Kaposi’s sarcoma also showed an increased number of mature CD83+ IDC than highly vascular oral lesions (p<0.001). There were significant alterations in the distribution of LC and IDC in AIDS-associated Kaposi’s sarcoma when compared to HIV-negative vascular oral lesions, suggesting that changes in their concentrations may play a role in the pathogenesis of Kaposi’s sarcoma.

https://doi.org/10.1590/0103-6440201902599 1103 downloads

Furuncular Myiasis Affecting the Lower Lip of a Young Patient
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Fonseca, Felipe Paiva

; Sabino-Bezerra Jr, José Ribamar

; Vargas, Pablo Agustin

; Almeida, Oslei Paes de

; Lopes, Marcio Ajudarte

; Santos-Silva, Alan Roger

Brazilian Dental Journal

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Out 2016, Volume 27 Nº 5 Páginas 625 - 628

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A miíase furuncular é uma infecção parasitária causada pelas larvas de insetos Dipterans após penetrar na pele saudável, causando um nódulo eritematoso contendo um poro central. Adicionalmente, uma sensação de movimento e dor intermitente pode ser sentida. Miíase furuncular acometendo a região oral e perioral é rara, frequentemente causando erros diagnósticos. Este artigo descreve um caso raro de miíase furuncular em um paciente do sexo masculino de 20 anos de idade que apresentou um nódulo eritematoso no lábio inferior. Uma cirurgia exploratória foi indicada para fins diagnósticos e curativos, com sucesso observado já na sessão seguinte. Após 3 anos de acompanhamento, o paciente está recuperado, sem sinais clínicos ou sintomas da doença.

Abstract Furuncular myiasis is a parasitic infection caused by the larvae of Dipteran insects after penetrating healthy skin, causing an erythematous nodule with a central pore. Additionally, the patient may feel a sensation of movement and intermittent pain. Furuncular myiasis affecting the oral and perioral region is rare, usually leading to misdiagnosis. This paper describes a rare case of furuncular myiasis in a 20-year-old healthy male patient who presented an erythematous nodule in the lower lip. An exploratory surgery was indicated for both diagnostic and curative purposes, with successful healing observed in the following appointment. After 3 years of follow-up, the patient is recovered, with no clinical signs or symptoms of the disease.

https://doi.org/10.1590/0103-6440201600528 5687 downloads

Fine Needle Aspiration Cytology and Intralesional Steroid Injection in a Central Giant Cell Granuloma Affecting the Gingiva: A New Clinical Approach
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Fonseca, Felipe Paiva

; Ribeiro, Ana Carolina Prado

; Santos-Silva, Alan Roger dos

; Vargas, Pablo Agustin

; Lopes, Marcio Ajudarte

Brazilian Dental Journal

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Jul 2013, Volume 24 Nº 4 Páginas 420 - 427

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O granuloma central de células gigantes (GCCG) é uma lesão benigna dos maxilares predominantemente encontrada na mandíbula de pacientes jovens do sexo feminino com um variado comportamento clínico. Apesar de o manejo cirúrgico representar a principal modalidade terapêutica para esta lesão, o uso de injeções intralesionais de esteróides tem sido recentemente proposto para seu tratamento. Além do manejo conservador, o uso da punção aspirativa por agulha fina (PAAF) para o diagnóstico do GCCG tem sido comprovado ser uma abordagem segura e eficiente, especialmente útil em casos de lesões localizadas em regiões estéticas. Descrevemos aqui um caso de GCCG estendendo-se para a gengiva adjacente em um paciente do sexo masculino, 15 anos de idade, diagnosticado por meio da PAAF e subsequentemente tratado com injeções intralesionais de uma solução de acetato de triancinolona e oleato de etanolamina que levou a uma importante remissão clínica, permitindo a realização de uma abordagem cirúrgica conservadora preservando a estética periodontal. Por este motivo, ambos os procedimentos podem ser considerados opções de manejo para o GCCG dos maxilares.

Central giant cell granuloma (CGCG) is a benign jaw lesion predominantly found in the mandible of young female patients with a variable clinical behavior. Although surgical management is regarded as the main treatment modality for this lesion, the use of intralesional injections of steroids has been recently advocated for its treatment. In addition to this conservative management, the use of fine needle aspiration cytology (FNAC) for diagnosing CGCGs has been proven a safe and efficient approach, especially useful in cases with lesions located in esthetic regions. Herein, it is described a case of CGCG extending to the overlying gingiva of a 15-year-old male patient diagnosed by FNAC and subsequently treated with intralesional injections of a solution of triamcinolone acetonide and ethanolamine oleate that led to an important clinical remission, allowing a more conservative surgical procedure for preservation of gingival esthetics. Therefore, both procedures can be considered as management options for CGCG of the jaws.

https://doi.org/10.1590/0103-6440201302196 4017 downloads Citado 1 vez em SciELO

Extranodal Nasal NK/T-Cell Lymphoma: A Rare Oral Presentation and FASN, CD44 and GLUT-1 Expression
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Pontes, Helder Antonio Rebelo

; Pontes, Flavia Sirotheau Correa

; Silva, Brunno Santos de Freitas

; Fonseca, Felipe Paiva

; Andrade, Bruno Augusto Benevenuto de

; Rizo, Victor Hugo Toral

; Romanach, Mario Jose

; Leon, Jorge Esquiche

; Almeida, Oslei Paes de

Brazilian Dental Journal

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Jun 2013, Volume 24 Nº 3 Páginas 284 - 288

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O linfoma de células natural killers (NK)/T extranodal é um tumor maligno agressivo com características clinicopatológicas distintas, caracterizadas por invasão e destruição vasculares, necrose proeminente, fenótipo linfocítico citotóxico e uma forte associação com o vírus Epstein-Barr. Relatamos aqui um caso de linfoma de células NK/T nasal extranodal, envolvendo o seio maxilar, assoalho de órbita, e interessantemente estendendo-se para a cavidade oral através do osso alveolar e mucosa vestibular, preservando o palato, levando a um diagnóstico inicial equivocado de doença periodontal agressiva. Ainda, nós investigamos pela primeira vez a expressão imunoistoquímica das proteínas Fatty acid sinthase (FASN) e glucose transporter 1 (GLUT-1) nesta neoplasia. FASN revelou uma forte expressão citoplasmática nas células neoplásicas, enquanto GLUT-1 e CD44 foram negativas. Estes achados sugerem que a expressão de FASN e a perda de CD44 podem estar envolvidas na patogênese do linfoma de células NK/T nasal extranodal, e que GLUT-1 não deve participar da adaptação das células tumorais ao ambiente de hipóxia. Estudos adicionais com séries maiores são necessários para confirmar nossos resultados iniciais.

Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant tumor with distinctive clinicopathological features, characterized by vascular invasion and destruction, prominent necrosis, cytotoxic lymphocyte phenotype and a strong association with Epstein-Barr virus. Here is reported an extranodal nasal NK/T-cell lymphoma case, involving the maxillary sinus, floor of the orbit, and interestingly extending to the oral cavity through the alveolar bone and buccal mucosa, preserving the palate, leading to a primary misdiagnosis of aggressive periodontal disease. Moreover, this work investigated for the first time the immunohistochemical expression of fatty acid synthase (FASN) and glucose transporter 1 (GLUT-1) proteins in this neoplasia. FASN showed strong cytoplasmatic expression in the neoplastic cells, whereas GLUT-1 and CD44 were negative. These findings suggest that the expression of FASN and the loss of CD44 might be involved in the pathogenesis of the extranodal nasal NK/T-cell lymphoma, and that GLUT-1 may not participate in the survival adaptation of the tumor cells to the hypoxic environment. Further studies with larger series are required to confirm these initial results.

https://doi.org/10.1590/0103-6440201302202 3577 downloads

10.

Effect of andiroba oil on periodontitis in Wistar rats
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Carmona, Glaucia Babeto

; Teixeira, Renan Kleber Costa

; Brito, Marcus Vinicius Henriques

; Pontes, Flavia Sirotheau Correa

; Andrade, Eloisa Helena Aguiar

; Fonseca, Felipe Paiva

; Costa, Ricardo Miranda Brito

; Carvalho, Francideise Martins

Acta Cirúrgica Brasileira

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Jun 2013, Volume 28 Nº 6 Páginas 430 - 434

Resumo: En | Texto: En | PDF: En

PURPOSE: To evaluate the effects of andiroba oil on the periodontitis in rats. METHODS: The periodontitis was induced by the placement of cotton ligatures around the cervix of the second upper molars on fifteen rats, and waiting fifty days. The animals were randomly distributed into three groups: saline group, andiroba oil group and meloxican group, differentiated by substance used in the treatment of periodontitis. The groups received the respective substance by gavage for seven days, after the periodontitis induced. It was analyzed the score of inflammatory cells and the measurement from the cemento-enamel junction to the bone crest. RESULTS: The andiroba oil group (p=0.008) and meloxican group (p=0.0347) show a less score of inflammatory cells than saline group, however there weren't difference between them (p=0.2754). Regarding the analysis of measurement from the cemento-enamel junction to the bone crest, there was no difference between groups studied (p=0.3451). CONCLUSION: Andiroba oil decreased the quantity of inflammatory cells, however, it didn't have an effect on the measurement of alveolar bone loss, like the treatment with Meloxican®.

3647 downloads Citado 1 vez em SciELO

11.

Intraosseous lipoma of the mandible: A diagnostic challenge
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Silva, Brunno Santos de Freitas

; Yamamoto, Fernanda Paula

; Pontes, Flávia Sirotheau Corrêa

; Fonseca, Felipe Paiva

; Pontes, Hélder Antônio Rebelo

; Pinto Júnior, Décio dos Santos

Revista Odonto Ciência

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2011, Volume 26 Nº 2 Páginas 182 - 186

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Relatar um caso raro de lipoma intra-ósseo em mandíbula e discutir os aspectos mais importantes desta lesão, enfatizando a desafio diagnóstico que esta entidade pode representar para cirurgiões dentistas e radiologistas. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 18 anos de idade apresentava uma lesão radiolúcida assintomática na mandíbula na região dos dentes 43 e 44 sem qualquer alteração clínica. Após a biópsia incisional, o exame histopatológico evidenciou uma lesão encapsulada composta majoritariamente por tecido adiposo benigno e algumas áreas de calcificações distróficas confirmando o diagnóstico de lipoma intra-ósseo. A lesão foi cirurgicamente removida e nenhum sinal de recorrência foi observado após seis meses de acompanhamento. CONCLUSÃO: Devido às características clínicas e radiográficas inespecíficas e à sua raridade, o lipoma intra-ósseo de mandíbula pode representar um desafio diagnóstico para cirurgiões dentistas e radiologistas. Portanto, o exame histopatológico é fundamental para o correto diagnóstico da lesão.

PURPOSE: To report a rare case of intraosseous lipoma of the mandible and to discuss the most important features of the lesion, emphasizing the diagnostic pitfall that this entity may represent for general dentists and radiologists. CASE DESCRIPTION: An 18-year-old male patient presented an asymptomatic radiolucent lesion in the mandible in the region of the teeth 43 and 44 with no clinical alteration. After the incisional biopsy the histopathological exam revealed a capsulated lesion predominantly composed of mature adipose tissue and some areas of dystrophic calcification confirming the diagnosis of intraosseous lipoma. The lesion was surgically removed and no signs of recurrence could be observed after six months of follow-up. CONCLUSION: Due to the unspecific clinical and radiographic features and its rarity the intraosseous lipoma of the mandible may be a diagnostic challenge for general dentists and radiologists. Therefore, the histopathological examination is required for the correct diagnosis of the lesion.

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12.

Computed tomography and scintigraphy exams for diagnosis and treatment planning of the condylar osteochondroma: a case report
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Yamamoto, Fernanda Paula

; Silva, Brunno Santos de Freitas

; Modes, Ricardo Wagner

; Fonseca, Felipe Paiva

; Pontes, Flávia Sirotheau Corrêa

; Sousa, Suzana Cantanhede O. M. de

Revista Odonto Ciência

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Dez 2010, Volume 25 Nº 4 Páginas 422 - 426

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Relatar um caso incomum de osteocondroma afetando o côndilo mandibular de uma paciente jovem e ilustrar as importantes contribuições dos diferentes exames por imagem para o diagnóstico e plano de tratamento desta lesão. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 24 anos, com queixa principal de uma crescente assimetria facial e dor na região pré-auricular esquerda, além de apresentar redução da abertura bucal, desvio de mandíbula e mordida cruzada posterior, por um período de 18 meses. A radiografia panorâmica revelou um aumento do côndilo esquerdo, enquanto secções de tomografia computadorizada e reconstrução 3D exibiram um crescimento ósseo bem definido originando-se do côndilo. O exame de cintilografia revelou uma atividade osteogênica anormal na região de articulação tempormandibular esquerda. O côndilo foi cirurgicamente removido e após 18 meses de acompanhamento a radiografia panorâmica e a tomografia computadorizada não revelaram nenhum sinal de recorrência. CONCLUSÃO: Apesar de o osteocondroma ser um tumor ósseo benigno que raramente surge na região crânio maxilofacial, ele deve ser considerado como diagnóstico diferencial para massas de crescimento lento na área temporomandibular e o uso de diferentes exames por imagem contribuem significativamente para o correto diagnóstico e plano de tratamento desta condição patológica.

PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.

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13.

Epidemiological and oral manifestations of HIV-positive patients in a specialized service in Brazil
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Pedreira, Erick Nelo

; Cardoso, Camila Lopes

; Barroso, Éder do Carmo

; Santos, Jorge André de Souza

; Fonseca, Felipe Paiva

; Taveira, Luís Antônio de Assis

Journal of Applied Oral Science

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Dez 2008, Volume 16 Nº 6 Páginas 369 - 375

Resumo: En | Texto: En | PDF: En

The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.

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