RESUMO O sarcoma de Ewing é um tumor maligno que surge principalmente de tecido ósseo, pelo qual sua apresentação extra-óssea não é muito comum, sendo ainda mais raro seu aparecimento em tecidos moles da cavidade bucal. O objetivo deste caso foi descrever as características clínicas de um Sarcoma de Ewing extra-ósseo em língua em paciente pediátrico. Refere-se a paciente escolar masculino de 11 anos de idade, quem acudiu a consulta de Medicina Bucal referindo um aumento de volume em língua. Intraoralmente observou-se lesão tumoral em borda lateral esquerda de língua, indurada, da mesma cor da mucosa com áreas ulceradas e bordas bem definidas, de aproximadamente 2,5cm. Foi indicada uma ressonância magnética cervical e maxilofacial, observando-se uma lesão hiperintensa, parcialmente delimitada e não infiltrante na zona descrita. Realizou-se biópsia incisional com diagnóstico histopatológico de Neoplasia maligna de células redondas azuis, o marcador de imunohistoquímica CD99, encontrado positivo neste caso foi chave para o diagnóstico definitivo. Uma tomografia abdominotorácico-pélvico foi requerida pelo serviço de Oncologia Pediátrica, além de aspirado e biópsia de medula óssea, nos quais não se evidenciaram infiltrações neoplásicas. Após quatro ciclos de quimioterapia, realizou-se a cisão da lesão e consecutivo estudo da peça cirurgica, indicando bordas livres de lesão. O sarcoma de Ewing é um tumor de comportamento agressivo, pelo qual este caso representa um achado de relevância clínica e epidemiológica, tanto por sua aparição extra-óssea quanto por seu comportamento inusual.

ABSTRACT Ewing’s sarcoma is a malignant tumor that arises mainly from bone tissue, so that its extra-osseous presentation is not very common and even more unusual, in the soft tissues of the oral cavity. The objective of this case was to describe the clinical characteristics of an extra-osseous Ewing’s Sarcoma of the tongue in a pediatric patient. An 11-year-old male school patient, who attended an oral medicine consultation referring a volume increase in the tongue. Intraorally, a tumoral lesion was observed on the left lateral edge of the tongue, indurated, with the same color of the mucosa with ulcerated areas, well defined edges and symptomatic on palpation, with an approximate size of 2.5 cm. A cervical and maxillofacial MRI was indicated, observing a partially delimited hyperintense and non-infiltrating lesion in the described area. An incisional biopsy was performed with histopathological diagnosis of malignant neoplasm of blue round cells, theCD99 marker was found to be positive in the immunohistochemical study and was key to the definitive diagnosis of this tumor. A thoraco-abdomino-pelvic tomography was requested by the Pediatric Oncology service, as well as biopsy and aspiration of bone marrow, in which no neoplastic infiltrations were evidenced. After four cycles of chemotherapy, total removal of the lesion was performed with a consecutive histopathological study of the surgical piece, indicating free edges of the lesion. Ewing’s sarcoma is a tumor with aggressive behavior, so this case represents a finding of clinical and epidemiological relevance, both due to its extra-osseous appearance and its unusual behavior.

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear, caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado.

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case.

Objetivo: Caracterizar las condiciones de salud-enfermedad bucal  de los pacientes adultos  VIH/SIDA pertenecientes  al Programa de infecciones de transmisión sexual  del Estado Zulia. Venezuela. Metodología: estudio transversal sobre una muestra  de pacientes (rango: 20-58 años. X=36.3 años de edad). Se determinó  estado de  la dentición y  necesidad de tratamiento periodontal utilizando criterios de la   OMS, se estableció  la  disfunción de la articulación temporo-mandibular (ATM), y para el diagnóstico de las lesiones bucales se siguieron los criterios clínicos descritos en la Clasificación Internacional de las lesiones bucales asociadas con la infección por el VIH. También se evaluó la higiene bucal. Resultados: El  58.9%  de los individuos tenían  5 a mas dientes afectados por caries dental y  58.9% requería algún tipo de tratamiento. 46.1% de los pacientes presentó más de 2/3 de la corona clínica con placa dentobacteriana. La condición periodontal mas prevalente fue el calculo dental (49.2%) El 77.2% de los pacientes  requerían  tratamiento periodontal. Se observó  17,1% de  casos con   candidiasis oral,  9,3% con herpes,  y  36.6% con ulceraciones aftosas. 54.1% de los pacientes. VIH/SIDA presentaron  xerostomia Conclusiones: deficientes condiciones de  salud bucal fueron encontradas en los  pacientes  de este estudio lo que propicia la aparición de infecciones oportunistas  que pueden complicar y comprometer aun mas su  salud general, esto evidencia la necesidad de profundizar en las respuestas  que se ofrecen en lo preventivo  y   curativo por parte del  Estado Venezolano respecto a la atención bucal.

Objective: To identify the conditions of oral health-illness in   patients VIH/SIDA of the Program of sexual transmission of the State Zulia. Venezuela. Materials and methods: study descriptive on a sample of patient (range: 20-58 years. X=36.3 years old) state of the teething, treatment needs periodontal and was evaluated using the criteria OMS, moreover, the dysfunction temporo-mandibular articulation (ATM), and the Index of Hygiene Oral Simplified were determined. The criteria   the International Classification of the buccal lesions associated with the infection by the VIH were use for the diagnosis of the oral   lesions. Resultados: 58.9% the individuals had 5 to more teeth affected by dental caries.  69.9%   required some treatment type. 46.1% had more 2/3 of the clinical crown with dental plaque. The periodontal condition more prevalent was the calculate dental (49.2%). 77.2% of the patients required periodontal treatment. 17.1% of cases had  oral candidiasis, 9,3%  herpes, and 36.6%  aphthous ulcerations. 54.1% of the patients. VIH/SIDA presented xerostomia. Conclusions: deficient conditions of oral health were found in the patients of this study, what propitiates the appearance of infections opportunists that can complicate the patient's general health, this evidences the necessity the answers in the preventive and curative in the programs health oral the part of the Venezuelan State.

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear,  caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado.

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized  by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case.

Objective: To analyze the behavior of pH and sodium bicarbonate (NAHCO3) in the saliva of patients with leukemia during the administration protocol for Methotrexate (Mtx). Materials and Methods: A controlled clinical essay was carried out on 23 patients between 4 and 18 years of age with high-risk Acute Lymphoblastic Leukemia. Sampling was carried out at To: basal condition; T1: 12 hours after intravenous administration of sodium bicarbonate, before administering Mtx and T2: 3 hours after administering Mtx, the time of maximum concentration. Chiron-Diagnostic 378® equipment was used to determine pH and sodium bicarbonate. The data was interpreted using Analysis of Variance at the 5% significance level. Results: The highest values of sodium bicarbonate were observed at T2, with salivary pH levels remaining within neutrality ranges, diminishing slightly in T1. Conclusion. In this study, the dose of sodium bicarbonate considered in the administration protocol of 3 g /m² Mtx, kept sodium bicarbonate levels in saliva at normal levels and pH neutral.

OBJETIVO: Determinar las modificaciones en las UFC de estreptococos mutans, lactobacilos y de la capacidad amortiguadora de la saliva como indicadores de riesgo a la caries dental en niños y adolescentes que reciben quimioterapia. MATERIALES Y MÉTODOS. La muestra estuvo conformada por 10 pacientes, entre 5 y 15 años de edad, con diagnóstico de Leucemias, Linfomas o Neuroblastoma, la cual fue seleccionada aleatoriamente de la población objeto de estudio. Para registrar la presencia de la enfermedad caries dental, se realizó una evaluación clínica siguiendo los criterios de la OMS/OPS. La evaluación microbiológica y de la capacidad amortiguadora de la saliva, se realizó antes y después del tratamiento quimioterapéutico, utilizando para ello la Prueba CRT Bacteria y CRT Buffer VIVADENT ®. RESULTADOS: Se evidenció un incremento significativo (p< 0.05) de las UFC de estreptococos mutans. En los niveles de lactobacilos y capacidad amortiguadora, no se observaron modificaciones significativas después de la quimioterapia. CONCLUSIONES: Los resultados de este estudio sugieren la influencia de los agentes citóstaticos en el aumento ocurrido en las UFC de estreptococos mutans.

OBJETIVE: To determine the modifications of streptococci mutans, lactobacillus and salivary buffer capacity as risk indicators of dental caries in children and adolescents undergoing chemotherapy. MATERIALS AND METHODS: The sample comprised 10 patients between 5 and 15 years of age, diagnosed with Leukemia, Lymphomas or Neuroblastomas. In order to register the presence or absence of dental caries, a clinical evaluation was included, in accordance with WHO/PHO criteria. Microbiological evaluation and saliva buffering capacity were carried out before and after the chemotherapeutic treatment, using the VIVADENT ® CRT Bacteria and CRT Buffer. RESULTS: These showed a significant increase (p< 0.05) in Mutans Streptococci CFU. No significant modifications in Lactobacilli and buffering capacity were observed. CONCLUSION: The modifications in Mutans Streptococci CFU suggest the influence of cytostatic agents.