RESUMEN Antecedentes: El granuloma de células plasmáticas (GCP) es una patología poco común que se caracteriza por una lesión roja e hiperplasia que presenta una gran afinidad a cualquier tejido blando con mayor frecuencia a nivel pulmonar y de manera poco usual a nivel oral como los labios, lengua y encía como un caso muy singular, histológicamente se caracteriza por un gran número de células plasmáticas. Objetivo: Reportar un caso poco común de GCP en encía con el abordaje, complicaciones y éxito del tratamiento del mismo. Descripción del caso: paciente femenino de 60 años de edad, acude a consulta por una lesión roja nivel de la encía marginal y adherida del maxilar superior. Al examen intraoral se observa una hiperplasia localizada Con diagnostico presuntivo de granuloma de células plasmáticas, donde se le realizaron exámenes radiográficos, posteriormente una biopsia, confirmando dicho diagnóstico. Conclusión: GCP se caracteriza clínicamente por presentar una hipertrofia gingival en la encía adherida, una de los lugares menos frecuentes a nivel oral. Esta patología al presentar ciertas similitudes clínica e histológicamente es muy difícil realizar un correcto diagnóstico de dicha patología.

ABSTRACT Background: Plasma cell granuloma (PCG) is an uncommon pathology characterized by a red lesion and hyperplasia that has a high affinity to any soft tissue, more frequently at the lung level and in an unusual way at the oral level such as lips, tongue and gingiva as a very unique case, histologically characterized by a large number of plasma cells. Objective: To report a rare case of GCP in the gingiva with the approach, complications and success of its treatment. Description of the case: a 60-year-old female patient comes to the clinic for a red lesion at the level of the marginal and attached gingiva of the upper jaw. Intraoral examination revealed localized hyperplasia with a presumptive diagnosis of plasma cell granuloma, where radiographic examinations were performed, followed by a biopsy, confirming said diagnosis. Conclusion: GCP is clinically characterized by presenting gingival hypertrophy in the attached gingiva, one of the least frequent places at the oral level. This pathology, as it presents certain clinical and histological similarities, is very difficult to make a correct diagnosis of said pathology.

RESUMO: A periodontite é um processo inflamatório de origem infecciosa que afeta os dentes e suas estruturas de suporte, causando perdas econômicas significativas e redução do bem-estar animal. As bactérias do biofilme gengival são um dos principais fatores envolvidos no início das lesões inflamatórias. As bactérias agem diretamente nos tecidos ou indiretamente por meio de substâncias que causam dano tecidual. Estudos sobre a etiopatogenia da periodontite em rebanhos ovinos brasileiros são escassos. O presente estudo teve como objetivo caracterizar histologicamente as lesões periodontais de ovinos de descarte da raça brasileira Santa Inês. Foram observadas lesões periodontais, como bolsas periodontais contendo tecido vegetal e bactérias, substituição do ligamento periodontal por tecido conjuntivo e células inflamatórias, pústulas superficiais, degeneração hidrópica epitelial e hiperplasia do epitélio. As alterações da submucosa foram caracterizadas por tecido de granulação, edema, tumefação das células endoteliais, bactérias e infiltrado inflamatório linfoplasmocitário predominantemente perivascular. No osso alveolar, observou-se reabsorção osteoclástica e aposição óssea. Este estudo revelou inflamação subaguda a crônica, reabsorção óssea alveolar e aposição de osso cortical na periodontite ovina. Assim, esses achados podem contribuir para a evolução do conhecimento sobre a etiopatogenia da periodontite ovina e para o desenvolvimento de medidas de controle da doença.

ABSTRACT: Periodontitis is an inflammatory process of infectious origin affecting the teeth and their supporting structures, causing significant economic losses and reducing animal welfare. Bacteria in the gingival biofilm are one of the main factors in initiating inflammatory lesions. Bacteria act directly on tissues or indirectly through substances that cause tissue damage. Studies on the etiopathogenesis of periodontitis in Brazilian sheep herds are scarce. The present study aimed to characterize histologically periodontal lesions of culled sheep from the Brazilian breed, Santa Inês. Periodontal lesions, such as periodontal pockets containing plant tissue and bacteria, replacement of the periodontal ligament by connective tissue and inflammatory cells, superficial pustules, hydropic epithelial degeneration, and epithelium hyperplasia, were observed. Submucosal changes were characterized by granulation tissue, edema, swelling of the endothelial cells, bacteria, and predominantly perivascular lymphoplasmacytic inflammatory infiltrate. In the alveolar bone, osteoclastic resorption and bone apposition were observed. This study revealed subacute to chronic inflammation, alveolar bone resorption, and cortical bone apposition in ovine periodontitis. Thus, these findings can contribute to the evolution of knowledge about the etiopathogenesis of ovine periodontitis and, possibly, the development of measures to control the disease.

Abstract Background: Leukemia cutis (LC) is the infiltration of neoplastic leukocytes into the skin, causing skin lesions. In children, it appears more frequently in patients with acute myeloblastic leukemia (AML), particularly in subtypes with a monocytic component. Methods: We studied a retrospective cohort including all AML cases from the Hospital Infantil de México Federico Gómez between January 2009 to December 2019 and described the clinical characteristics of those who presented LC and other mucocutaneous manifestations. The information was collected from clinical records and analyzed using SPSS software (version 17). Results: We identified 54 AML cases: 53.7% were males, and 75.9% of the patients presented at least one dermatosis in the course of the disease. LC was clinically present in 14.8% of patients and was histologically confirmed in 9.2% of them; two congenital leukemia cases were identified. Among these patients, LC was more frequent in males. LC patients were younger than those without LC, the most frequent AML subtype was M2 (37.5%), and the most frequent clinical manifestations were plaques, chloromas, and gingival hyperplasia. None of the patients presented LC before AML diagnosis. Conclusions: Currently, only a few studies about LC on pediatric populations have been reported, and the existing ones have small sample sizes. We found clinical and epidemiological similarities with other populations in the studied sample.

Resumen Introducción: La leucemia cutis (LC) es la infiltración de leucocitos neoplásicos a la piel que provoca lesiones cutáneas. En la población infantil aparece con más frecuencia en pacientes con leucemia mieloblástica aguda (LMA), principalmente en los subtipos con componente monocítico. Métodos: Se estudió una cohorte retrospectiva en el Hospital Infantil de México Federico Gómez entre enero de 2009 y diciembre de 2019 para conocer las características clínicas de los pacientes con LMA que cursaron con LC y otras manifestaciones mucocutáneas. La información se recabó de los expedientes clínicos y se analizó con el programa estadístico SPSS versión 17. Resultados: Se identificaron 54 casos de LMA: el 53.7% en el sexo masculino y el 46.3% en el sexo femenino. El 75.9% de los pacientes presentaron alguna dermatosis durante el curso de su enfermedad. La LC se presentó clínicamente en el 14.8% de los pacientes y se confirmó histológicamente en el 9.2% de ellos; dos casos correspondieron a leucemia congénita. De estos pacientes, la LC fue más frecuente en el sexo masculino, los pacientes fueron más jóvenes que el grupo sin LC, el subtipo de LMA más frecuente fue el M2 (37.5%) y las principales manifestaciones clínicas fueron placas infiltradas, cloromas e hiperplasia gingival. Ninguno de los pacientes presentó LC antes del diagnóstico de LMA. Conclusiones: Hasta ahora existen pocos estudios de LC en las diferentes variedades de leucemia en la población infantil, y los existentes cuentan con un tamaño de muestra pequeño. En este estudio se reportan estadísticas descriptivas y se encuentran similitudes clínico-epidemiológicas con otras poblaciones.

Resumen Objetivo: Describir las características bucales prevalentes de pacientes argentinos con mucopolisacaridosis (MPS) atendidos en el Servicio de Odontología del Hospital Nacional “Prof. Alejandro Posadas”. Materiales y métodos: Se consideraron las historias clínicas de 19 pacientes con diagnóstico de MPS. Se registraron la edad, el sexo, el lugar de residencia, el tipo de MPS y la presencia de retraso madurativo. La muestra estuvo constituida por 13 niños (6,7±3 años) y 6 adultos (26±9 años): 2 eran mujeres (1 con MPS tipo I; 1 con MPS tipo IV A) y 17 eran hombres (15 con MPS tipo 2; 1 con MPS tipo 1; 1 con MPS tipo III); 13 de los pacientes presentaban discapacidad intelectual. Se evaluaron: tipo de dentición, oclusión, macroglosia, hipoplasias del esmalte, tipo de respiración predominante, clase molar y tratamiento realizado. Resultados: Ambos casos con MPS I presentaban mordida abierta anterior y giroversión dental, y solo uno de estos, diastemas, microdoncia, hipoplasias del esmalte, macroglosia y respiración bucal. De los 15 pacientes con MPS II, 11 presentaban mordida abierta anterior (73%), 3 mordida cruzada posterior (20%), 5 giroversión dental (33%), 11 diastemas (73%), 3 retraso en la erupción (20%), 4 hiperplasia gingival (26%), 13 macroglosia (87%), 7 hipoplasias del esmalte (47%), 2 microdoncia (13%), 9 respiración bucal (60%). Se registraron 5 pacientes con clase molar I (33%), 3 con clase molar II (20%), 3 con clase molar III (20%) y en 3 casos no se pudo evaluar (20%). En el paciente con MPS tipo III se halló mordida abierta anterior, diastemas, retraso en la erupción, macroglosia, respiración bucal y clase molar II; y en el caso de MPS tipo IV A, mordida abierta anterior, diastemas, hiperplasia gingival, macroglosia y clase molar II. El 90% de los pacientes requirió tratamiento odontológico. Conclusión: Las manifestaciones bucales más observadas fueron macroglosia (84,2%) y mordida abierta anterior (79%).

Abstract Aim: To identify the most prevalent oral manifestations of 19 Argentine patients with mucopolysaccharidos (MPS) attending the Dentistry Service of the National Posadas Hospital. Materials and methods: The medical records of 19 patients diagnosed with MPS were considered. Age, sex, place of residence, type of MPS, and presence of maturational delay were recorded. The sample consisted of 13 children (6.7 ± 3 years) and 6 adults (26 ± 9 years): 2 were women (1 with MPS type I; 1 with MPS type IV A) and 17 were men (15 with MPS type 2; 1 with MPS type 1; 1 with MPS type III); 13 of the patients had intellectual disabilities. The following were evaluated: type of dentition, occlusion, macroglossia, enamel hypoplasia, predominant type of respiration, molar class and treatment performed Results: Both cases with MPS I presented anterior open bite and dental gyroversion, and only one of these, diastemas, microdontia, enamel hypoplasia, macroglossia and mouth respiration. Of the 15 patients with MPS II, 11 presented anterior open bite (73%), 3 posterior crossbite (20%), 5 dental gyroversion (33%), 11 diastemas (73%), 3 delayed eruption (20%), 4 gingival hyperplasia (26%), 13 macroglossia (87%), 7 enamel hypoplasia (47%), 2 microdontia (13%), 9 mouth breathing (60%). 5 patients with molar class I (33%), 3 with molar class II (20%), 3 with molar class III (20%) and in 3 cases it could not be evaluated (20%). In the patient with type III MPS, anterior open bite, diastemas, delayed eruption, macroglossia, mouth breathing and molar class II were found; and in the case of type IV A MPS, anterior open bite, diastemas, gingival hyperplasia, macroglossia and molar class II. 90% of the patients required dental treatment. Conclusion: The most observed oral manifestations were macroglossia (84.2%) and anterior open bite (73%).

Resumo Este artigo relata a abordagem da saúde oral de uma criança com a síndrome de Coffin Siris. Esta síndrome é uma anomalia congénita multi-sistémica causada por mutações em genes do complexo BRG-1. Os indivíduos com esta síndrome apresentam hipo ou aplasia das unhas ou das falanges do quinto dedo. Outras características incluem deficiência de crescimento, atraso de desenvolvimento intelectual e anormalidades do sistema de órgãos. O exame clínico revelou hiperplasia gengival na arcada superior, presença de biofilme e cárie dentária nos molares decíduos e permanentes inferiores. Orientações sobre higiene oral e hábitos alimentares foram fornecidas aos responsáveis, além da extração e restauração dos dentes com cimento de ionómero de vidro. Este caso sugere que esses pacientes necessitam de atendimento domiciliar e consultas odontológicas periódicas para tratamento preventivo e sistemático para que se alcance a melhoria da qualidade de vida. A paciente está sendo monitorizada e sua condição oral melhorou.

Abstract This paper reports the oral health approach of a child with Coffin-Siris syndrome. This syndrome is a multisystem congenital anomaly caused by mutations in genes of BRG- 1-associated factors complex. Individuals with this syndrome have been described with hypoplasia or aplasia of the fifth digit nails or phalanges. Other features include growth deficiency, developmental and intellectual delay, and other organ-system abnormalities. Clinical examination revealed gingival hyperplasia in the upper arch, dental biofilm, and dental caries on the lower deciduous and permanent molars. Guidelines on oral hygiene and dietary habits were provided to the guardians, and tooth extraction and restoration with glass-ionomer cement were performed. This case suggests that these patients require home care and periodic dental consultations for preventive and systematic dental treatment and quality of life improvement. The patient is being monitored, and her oral condition has improved.

ABSTRACT Introduction: medicated gingival enlargement is the most widespread undesirable effect of systemic medication on periodontal tissues, the most frequently implicated drugs are phenytoin, cyclosporine and nifedipine, and there is no consensus on exact prevalence figures. Objective: to characterize medicinal gingival enlargement in patients suffering from hypertension, cardiopathy and epilepsy at the Family Physician's Office 21-8 of the “XX Aniversario” Polyclinic. Method: a cross-sectional, descriptive, observational study was conducted. Cases were selected by intentional non-probabilistic sampling by criteria, the sample was made up of 46 people. Theoretical and empirical methods were applied that included the application of epidemiological indices. The information was grouped in tables of contingencies and frequencies. Results: the prevalence of gingival enlargement was 4.3% without distinction of age or sex and it affected those who suffer from epilepsy. Phenytoin and carbamazepine were the drugs that produced it, risk factors were identified: age, sex, time and dose of drug consumption, oral hygiene and periodontal condition. Conclusions: prevalence of gingival enlargement was low, with severity grade 2 and 3, exclusive of epileptic patients treated with carbamazepine and phenytoin. It affected equally young people of both sexes. Poor oral hygiene and chronic inflammatory periodontal disease were present.

RESUMEN Introducción: el agrandamiento gingival medicamentoso es el efecto indeseado más extendido de la medicación sistémica sobre los tejidos periodontales, se implican con mayor frecuencia los medicamentos: fenitoína, ciclosporina y nifedipina, y no existe consenso respecto a las cifras exactas de prevalencia. Objetivo: caracterizar el agrandamiento gingival medicamentoso en pacientes que padecen hipertensión, cardiopatía y epilepsia del Consultorio del Médico de la Familia 21-8 del Policlínico “XX Aniversario”. Método: se realizó un estudio descriptivo observacional de corte transversal. Se seleccionaron los casos por muestreo no probabilístico intencional por criterios, la muestra quedó conformada por 46 personas. Se aplicaron métodos teóricos y empíricos que incluyeron la aplicación de índices epidemiológicos. La información se agrupó en tablas de contingencias y frecuencias. Resultados: la prevalencia de agrandamiento gingival fue de 4,3% sin distinción de edad ni sexo y afectó a los que padecen epilepsia. La fenitoína y la carbamazepina fueron los medicamentos que lo produjeron, se identificaron los factores de riesgo: edad, sexo, tiempo y dosis de consumo del fármaco, higiene bucal y estado periodontal. Conclusiones: la prevalencia de agrandamiento gingival fue baja, con severidad grado 2 y 3, exclusiva de pacientes epilépticos tratados con carbamazepina y fenitoína. Afectó por igual a jóvenes de ambos sexos. La higiene bucal deficiente y la enfermedad periodontal inflamatoria crónica estuvieron presentes.

RESUMEN Introducción: la hipertrofia gingival (HG) es el aumento descontrolado del volumen de la encía debido a diversos factores etiológicos, entre ellos el tratamiento ortodóntico. Esta patología se caracteriza por cambios del tejido epitelial y conectivo, incluyendo modificaciones en la matriz extracelular. El presente estudio determinó la presencia y distribución de colágeno tipo III en tejidos de pacientes con HG portadores de ortodoncia fija. Métodos: se obtuvieron 12 muestras de tejido gingival de pacientes sometidos a cirugías periodontales. Se dividieron en dos grupos, el primero, integrado por pacientes sanos (control; n=6), y el segundo por pacientes diagnosticados con HG con ortodoncia (pacientes; n=6). Cada muestra obtenida fue sometida a la coloración hematoxilina-eosina, Masson-Goldner e inmunohistoquímica del colágeno tipo III. Resultados: las tinciones histológicas hematoxilina-eosina y Masson-Goldner permitieron constatar hiperplasia del tejido epitelial y un tejido conectivo denso con notable aumento de las fibras de colágeno en el tejido gingival de los pacientes con HG portadores de ortodoncia en comparación con los individuos del grupo control. El tejido gingival de pacientes con HG por ortodoncia evidenció una distribución y localización del colágeno tipo III cerca de la lámina basal, alrededor de los vasos sanguíneos, pero a diferencia del grupo control, su localización fue notoria en toda la extensión del tejido conectivo. Conclusión: los tejidos gingivales de pacientes con HG portadores de ortodoncia experimentan aumento en número y densidad de las fibras de colágeno. El colágeno tipo III parece perder su localización habitual en los tejidos gingivales de pacientes con HG portadores de ortodoncia.

ABSTRACT Introduction: gingival hypertrophy (GH) is the uncontrolled increase in gingival volume induced by different etiological factors, including orthodontic treatment. This pathology is characterized by changes in epithelial and connective tissue, including modifications in the extracellular matrix. The present study determined the presence and distribution of type III collagen in tissues of patients with GH wearing fixed orthodontic appliances. Methods: 12 samples of gingival tissue were obtained from patients undergoing periodontal surgery. They were divided into two groups, the first with healthy patients (control; n = 6) and the second with patients diagnosed with GH and orthodontic treatment (patients; n = 6). Each obtained sample was subjected to the hematoxylin-eosin stain, Masson-Goldner staining, and type III collagen immunohistochemistry. Results: the hematoxylin-eosin and Masson-Goldner histological stains showed hypertrophia of epithelial tissue and connective tissue with a marked collagen fiber increase in the gingival tissue of orthodontic wearers with GH compared to individuals in the control group. The gingival tissue of patients with GH caused by orthodontic treatment showed a distribution and location of type III collagen near the basal lamina, around the blood vessels, but unlike the control group, its location was noticeable throughout the connective tissue. Conclusion: the gingival tissues of orthodontic wearers with GH experience an increase in the number and density of collagen fibers. Type III collagen seems to lose its usual location in the gingival tissues of orthodontic wearers with GH.

RESUMO O caso clínico de um adolescente de 12 anos de idade, atendido no Departamento de Ortodontia da Clínica Estomatológica Provincial "Mártires del Moncada" de Santiago de Cuba, diagnosticado com retenção do incisivo central superior direito, foi descrito mais de dois anos e para os quais ele recebeu tratamento com aparelhos fixos antes do bloqueio dentário e monitoramento clínico-radiográfico. Durante o procedimento ortodôntico, é encaminhado ao Departamento de Periodontia por apresentar na área do referido dente um aumento no volume rosa coral, de consistência dura e aparência fibrosa, o que impossibilitou a incorporação definitiva do dente em seu arco e plano de oclusão. Foram realizados os exames complementares correspondentes, diagnosticada hiperplasia gengival fibrosa localizada e realizado tratamento cirúrgico (gengivectomia), o que permitiu o tratamento ortodôntico sem envolvimento psicológico e social do paciente. A baixa frequência de ocorrência desse tipo de lesão associada à retenção dos incisivos centrais superiores motivou este relato de caso.

ABSTRACT It was described a clinical case of a 12-year-old adolescent, treated at the Orthodontic Department of the Provincial Stomatological Clinic "Mártires del Moncada" in Santiago de Cuba, who was diagnosed with retention of the upper right central incisor more than two years ago and for which he received treatment with fixed appliances prior to tooth straightening and clinical-radiographic follow-up. During the orthodontic procedure, he was referred to the Department of Periodontics because he had a coral pink increase in volume in the area of that tooth, with a hard consistency and fibrous appearance, which made it impossible to definitively incorporate the tooth into its arch and occlusion plane. The corresponding complementary examinations were carried out, localized fibrous gingival hyperplasia was diagnosed and surgical treatment (gingivectomy) was performed, which allowed the successful completion of orthodontic treatment without any psychological or social implications for the patient. The rare occurrence of this type of injury associated with retention of upper central incisors motivated this case report.

RESUMEN Se describió el caso clínico de un adolescente de 12 años de edad, atendido en el Departamento de Ortodoncia de la Clínica Estomatológica Provincial "Mártires del Moncada" de Santiago de Cuba, al cual se le diagnosticó retención del incisivo central superior derecho hace más de dos años y para la cual recibió tratamiento con aparatología fija previo entorche del diente y seguimiento clínico-radiográfico. Durante el proceder ortodóncico, es remitido al Departamento de Periodoncia por presentar en la zona de dicho diente un aumento de volumen de color rosa coral, de consistencia dura y aspecto fibroso, que imposibilitó la incorporación definitiva del diente en su arco y plano de oclusión. Se realizaron los exámenes complementarios correspondientes, se diagnosticó hiperplasia gingival fibrosa localizada y se realizó tratamiento quirúrgico (gingivectomía), lo que permitió llevar a feliz término el tratamiento ortodóncico sin ninguna implicación psicológica y social para el paciente. La poca frecuencia de aparición de este tipo de lesión asociada a la retención de incisivos centrales superiores motivó el presente informe de caso.

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.

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 Introdução A terapia de implantes dentais, quando bem planejada, pode contribuir para a qualidade de vida do paciente e é uma ferramenta importante para solucionar um sério problema de saúde pública em várias partes do mundo. Objetivo Este estudo investigou a saúde peri-implantar em implantes fixos apoiados por uma técnica de carga imediata e associou esses resultados a condições sociodemográficas. Material e método Após a desmontagem das próteses sobre implantes com o “Modelo de Branemark”, a avaliação peri-implantar de 93 pacientes foi avaliada por meio do índice de placa dental (IPD), profundidade de sondagem (PS), sangramento à sondagem (SS), níveis clínicos de fixação (NCF) e presença de hiperplasia gengival. Os pacientes também responderam a um questionário sobre sexo, idade, nível socioeconômico (Associação Brasileira de Empresas de Pesquisa - ABEP), saúde geral e tabagismo. Resultado Os achados clínicos mais constantes foram a presença de placa, seguida de hiperplasia gengival e periimplantite, que esteve associada à progressão da doença. A maioria dos pacientes do estudo era do sexo feminino, caucasiana e com idade inferior a 60 anos, com próteses localizadas na arcada inferior, pertencentes às classes sociais A e B. Conclusão A presença de biofilme dentário ocorreu em quase todos os implantes e não foi relacionado à presença de periimplantite. A progressão da peri-implantite com perda óssea foi relacionada ao sangramento subgengival. As características sociodemográficas do estudo não apresentaram grandes correlações com as variáveis clínicas dos implantes dentários estudados.

ABSTRACT Introduction Dental implant therapy, when well planned, can contribute to the patient's quality of life and is an important tool for solving a serious public health problem in various parts of the world. Objective This study investigated peri-implant health in fixed implants supported by an immediate loading technique and to associate those outcomes with sociodemographic conditions. Material and method After the disassembly of the prostheses on implants with the “Branemark Model” the peri-implant health of 93 patients was evaluated using dental plaque index (DPI), probing pocket depths (PPD), bleeding on probing (BOP), clinical attachment levels (CAL), and presence of gingival hyperplasia. Patients also answered a questionnaire about their gender, age, socioeconomic status (Brazilian Association of Research Companies - ABEP), general health and tobacco use. Result The most constant clinical findings were the presence of plaque, followed by gingival hyperplasia and periimplantitis, which was associated with disease progression. Most of the patients in the study were female, Caucasian, and under 60 years of age, with prostheses located in their lower arch, and they belonged to social classes A and B. Conclusion The presence of dental biofilm occurred in almost all implants and was not related to the presence of periimplantitis. The progression of periimplantitis with bone loss was related to sub gingival bleeding. The sociodemographic characteristics in the study did not present great correlations with the clinical variables of the dental implants studied.

The case report of an adolescent that was assisted in the Periodontics Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba is described. He presented enlargement of the gums for more than a year, which made mastication of foods difficult and therefore, transitory digestive dysfunctions took place, besides affecting her aesthetics. After the physical and complementary tests, the presumptive diagnosis of hereditary or family gingival hyperplasia was established and the treatment was indicated into 3 phases: initial phase, surgical corrective phase and that of periodontal support. In the surgical phase a tissue sample was taken which pathologic analysis confirmed the initial presumptive diagnosis

Se describe el caso clínico de una adolescente que fue atendida en la consulta de Periodoncia del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, por presentar agrandamiento de las encías desde hacía más de un año, lo que le dificultaba la masticación de los alimentos y, por tanto, le producía trastornos digestivos transitorios, además de afectar su estética. Luego de realizados los exámenes físico y complementarios, se estableció el diagnóstico presuntivo de hiperplasia gingival hereditaria o familiar y se indicó el tratamiento, que incluyó 3 fases: la inicial, la correctiva quirúrgica y la de soporte periodontal. En la fase quirúrgica se tomó una muestra hística cuyo análisis anatomopatológico confirmó el diagnóstico presuntivo inicial

Abstract The present article purports the aim of showing, in a series of cases, the application of excisional biopsy with gingivoplasty technique as treatment of pyogenic granuloma. It can be observed that accurate excision as well as elimination of contributing factors considerably decreases recurrence probabilities. Presence of pyogenic granuloma has been described in this report of a series of cases related to pregnancy, local factors such as absence of interproximal contact, presence of calculi and poor oral hygiene indexes. Moreover, it is recommended that oral hygiene instruction be the first step in treatment of pyogenic granuloma, and that after lesion excision patients receive supporting periodontal therapy.

Resumen Este artículo tiene el propósito de mostrar en una serie de casos la aplicación de la técnica de biopsia excisional con gingivoplastia como tratamiento del granuloma piógeno. También se puede observar que la correcta extirpación; así como la eliminación de los factores con tribuyentes disminuye considerablemente la probabilidad de recidiva. En este reporte de serie de casos se ha descrito la presencia del granuloma piógeno relacionado al estado de gestación, a factores locales como ausencia de contacto interproximal, presencia de cálculo e índices de higiene oral malos. Además, se recomienda que la Instrucción de higiene oral sea el primer paso en el tratamiento del granuloma piógeno y que posteriormente a la extirpación de la lesión los pacientes reciban terapia periodontal de soporte.

Background: leukemia is considered a malignant neoplasm that is developed in the marrow bone. In this entity the inflammatory response in the presence of local irritants is higher and the defensive capacity is diminished. The specific diagnosis of leukemia demands a good interrogation, complete physical exam and detailed hematological studies. Objective: to present a case of acute myeloid leukemia which developed periodontal manifestations and to describe the treatment of leukemias. Clinical case: it is presented the case of a patient with loss of the generalized gingival morphology of spongy consistency, hipercolored, with a no painful increase in volume and that in some places covered the full crown of the teeth, ulcerated lesions, halitosis and submandibular lymphadenopathy. It was decided through the questioning and the periodontal clinical manifestations analysis, the remission of the patient to the Clinical Hematology Service, where laboratory tests were carried out, in addition it was confirmed the presence of acute myeloid leukemia and the patient was attended until he died. Conclusions: the dentists should know the periodontal manifestations of leukemia to carry out the convenient remission of the patient to a Service of Clinical Hematology, and to eliminate the local factors, the meticulous control of dental plaque, the regular professional cleaning and rinses with chlorhexidine with the purpose to alleviate the lesions in the mouth. The patient's physician should always be consulted before carrying out any treatment.

Fundamento: la leucemia se considera una neoplasia maligna que se desarrolla en la médula ósea. En esta enfermedad la respuesta inflamatoria en presencia de irritantes locales es mucho mayor, la capacidad defensiva está disminuida y las manifestaciones bucales son de las primeras en aparecer. El diagnóstico específico de la leucemia demanda un buen interrogatorio, examen físico completo y estudios hematológicos minuciosos. Objetivo: presentar un caso de leucemia mieloide aguda que desarrolló manifestaciones periodontales y describir el tratamiento periodontal de las leucemias. Caso clínico: se presenta el caso de un paciente con pérdida de la morfología gingival generalizada, encías hipercoloreadas, con aumento de volumen no doloroso, de consistencia esponjosa, que en algunos sitios cubría la corona completa de los dientes, lesiones ulceradas, halitosis y adenopatías submandibulares. A través del interrogatorio y el ánalisis del cuadro clínico periodontal se decidió la remisión al servicio de Hematología Clínica, donde se le practicaron los exámenes de laboratorio, se confirmó la presencia de una leucemia mieloide aguda y el paciente fue atendido hasta su fallecimiento. Conclusiones: los estomatólogos deben conocer las manifestaciones periodontales de la leucemia para realizar la remisión oportuna del paciente a un servicio de Hematología Clínica o Medicina Interna, y efectuar la eliminación de los factores locales, el minucioso control de la placa dental, la limpieza profesional regular y enjuagues con clorhexidina con vistas a aliviar las lesiones en la boca. El médico del paciente siempre debe ser consultado antes de llevar a cabo cualquier tratamiento.

RESUMO A dor é caracterizada como uma experiência sensorial e emocional, de forma desagradável e pessoal. Geralmente está associada a um dano tissular real, podendo ser causada pelo envolvimento de agentes químicos e físicos ou também por aspectos subjetivos e psicológicos. Esta pesquisa objetivou revisar a literatura a respeito do uso dos anticonvulsivantes no tratamento da dor crônica, os fármacos mais utilizados, a eficácia de cada um deles, os prós e os contras do uso desses medicamentos e as patologias associadas à dor crônica. As dores orofaciais são consideradas complexas e multifatoriais e não costumam responder bem ao tratamento com analgésicos comuns. A Carbamazepina é utilizada desde a década de 60, mas o seu uso prolongado pode alterar as funções hepáticas. A Fenitoína quando consumida por mais de três meses causa hiperplasia gengival e o Clonazepam reduz em até 70% a sintomatologia dos pacientes. Portanto, com o intuito de melhorar a qualidade de vida dos pacientes acometidos pela dor crônica, é que foram introduzidos no mercado farmacêutico os anticonvulsivantes. Pelo fato desse quadro clínico ser extremamente subjetivo e individual, é necessário que haja embasamento científico para realizar de forma correta o diagnóstico e tratamento dessa condição.

ABSTRACT Pain can be characterized as a sensorial and emotional experience in an unpleasant and personal way. It is usually associated with real tissue damage and may be caused by the involvement of chemical and physical agents or by subjective and psychological aspects. This study aimed to review the literature regarding the use of anticonvulsants in the treatment of chronic pain, the most used drugs, the efficacy of each one of them, the pros and cons of their use and the pathologies associated with chronic pain. Orofacial pains are considered complex and multifactorial and often do not respond well to treatment with common analgesics. The carbamazepine is used since the 60s, but their prolonged use can alter liver function. Phenytoin when consumed by more than three months cause gingival enlargement and clonazepam reduces patient symptomatology up to70%. Therefore, in order to improve the quality of life of patients suffering with chronic pain, the anticonvulsant drugs were introduced to the pharmaceutical market. As this problem is extremely subjective and individual, there must be scientific evidence to correctly perform the diagnosis and treatment of this condition.

Gingival enlargement is an abnormal increased volume of the gum that induces cosmetic changes and clinical symptoms, such as gingival bleeding, periodontal disorders, pathological tooth migration, among others. This condition can be a side effect of certain drugs such as anticonvulsants, calcium channel blockers, and immunosuppressants. A 74 year-old male patient with a medical record of kidney transplant secondary to chronic renal failure receiving cyclosporine for the past 14 years is referred to our Hospital with the chief complaint of gingival enlargement. The treatment is based on tooth extractions, biopsy and periodontal treatment. A complete regression of the lesion was observed after two months. The current approach to treat this disease is focused on plaque control. A multidisciplinary approach should be used and clinical protocols prepared that allow early treatment and avoidance of more aggressive disease expression.

El agrandamiento gingival (AG) es el aumento de volumen anormal de la encía que genera cambios estéticos y síntomas clínicos como sangrado gingival espontáneo o inducido, trastornos periodontales y migración patológica dentaria, entre otros. Este proceso patológico puede ser un efecto secundario a ciertos fármacos como anticonvulsivantes, bloqueadores de canales de calcio e inmunosupresores. Se presenta el caso de un paciente sexo masculino de 74 años de edad con antecedentes de trasplante renal, en tratamiento con ciclosporina, que acude por aumento del volumen intraoral, clínicamente compatible con agrandamiento gingival. Se realiza tratamiento basado en exodoncias, biopsia y control de placa. A los 2 meses se pudo observar una regresión de la lesión, y se confirma el diagnóstico con el estudio histopatológico. El manejo actual del tratamiento de esta enfermedad se basa en el control de la placa. Se sugiere dar un enfoque multidisciplinario y crear protocolos para derivar oportunamente antes de la expresión más agresiva de la enfermedad.