Evaluation of salivary flow in patients during head and neck radiotherapy

A radioterapia é um tratamento comumente empregado em pacientes portadores de carcinomas espinocelulares em cabeça e pescoço. Entre os efeitos colaterais locais, a xerostomia é um dos mais importantes. Com o objetivo de avaliar o efeito da radioterapia sobre o fluxo salivar, foram feitas 3 coletas salivares: no início, em um período intermediário e posteriormente ao tratamento radioterápico. Os resultados obtidos demonstraram médias de fluxo salivar semelhantes entre a coleta inicial e o grupo controle. Com o decorrer da radioterapia, houve diminuição significativa do fluxo salivar na coleta intermediária (p = 0,0008), que se manteve após o término da radioterapia (p = 0,0009). Nosso estudo enfatiza que há redução significativa do fluxo salivar durante e após a radioterapia.Radiotherapy is frequently employed for the treatment of head and neck squamous cell carcinoma. Among the side effects, xerostomia is one of the most important. With the objective of evaluating the role of radiotherapy in salivary flow, we performed three salivary sample collections: at the beginning of, during, and immediately after radiotherapy. The results showed that the salivary flow values of the first collection were very similar to those of the control group. However, during treatment, there was a significant decrease of the salivary flow (p = 0.0008), which continued low immediately after radiotherapy (p = 0.0009). Our study showed that radiotherapy leads to an important reduction of salivary flow during and after radiotherapy

Analysis of familial incidence of non-syndromic cleft lip and palate in a Brazilian population

Background: The purpose of this study is to follow the familial incidence of non-syndromic or isolated cleft lip, with or without cleft palate (NSCL/P), and to analyze the relationships between the type of NSCL/P in the affected individual and his/her parent, looking at children in the first grade. Material and Methods: To investigate the familial incidence of NSCL/P we analyzed the records of 185 patients from 2004-2008, retrospectively. Detailed histories were collected regarding the familial incidence of NSCL/P. For the 185 individuals, the relationship between the type of NSCL/P and the sociodemographic and personal characteristics of the affected person and her/his cleft relatives was obtained. Results: The individuals were 42 carriers of CL, 109 with CLP (joined in one group) and 34 with CP (p<0.001). Of the total of participants, 65 (35.13%) presented a positive history of cleft in their families and 120 (64.86%) presented a negative history (p<0.001). There were differences between the cleft groups according to types of cleft and positive familial history (p<0.001). In both groups, the relatives with higher incidence of NSCL/P were cousins, with the same pattern of distribution between the two groups (p=0.175). Conclusions: Most frequently, fissures result from CL/CLP with no familial history. However, CL/CLP was found in familial cases and cousins were the relative type more likely to be affected

Ameloblastic fibro-odontoma : a conservative surgical approach

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumor that occurs predominantly in children and young adults with no gender predilection and anatomic site, usually appearing as a painless swelling. We present a case of an 11-year-old non-Caucasian boy complaining of large painless isolated swelling in the right mandibular body. Intraoral examination revealed a tumoral mass with cortical bone expansion, covered by normal mucosa measuring 4.0 x 2.0 cm, located on both the lingual and buccal surfaces of the right body of the mandible, with displacement of the neighboring teeth. Panoramic radiography revealed an expansile, radiolucent and well circumscribed lesion with scattered foci of calcified material, which contained several radiopaque bodies of varying sizes and shapes. The provisional diagnoses were odontoma or AFO/ Biopsy confirmed AFO. The patient was treated with conservative surgery. After two years of follow-up, no alteration or recurrence was detected

Orofacial features of Treacher Collins syndrome

Treacher Collins syndrome (TCS) is a rare autosomal dominant disorder of craniofacial development. Major features include midface hypoplasia, micrognathia, microtia, conductive hearing loss, and cleft palate. The present study is on the orofacial features of 7 Brazilian patients with sporadic TCS aged 4 to 38 years. All patients presented the typical down-slanting palpebral fissures, colobomas, zygomatic and mandibular hypoplasia, partial absence of the lower eyelid cilia, and abnormalities of the ears. Malocclusion was present in all patients, and an anterior open bite was found in 3 patients. None of the patients had a cleft palate

Goldenhar syndrome: clinical features with orofacial emphasis

OBJECTIVES: Goldenhar syndrome (GS) is a relatively common developmental disorder characterized by craniofacial anomalies in association with vertebral, cardiac, renal, and central nervous system defects. This paper describes GS features with special emphasis on oral characteristics. MATERIAL AND METHODS: The clinical features of 6 patients with GS aged 3 months to 12 years are described, and a brief review of the literature about this genetic disorder is presented. RESULTS: All patients demonstrated the classical triad of GS, including mandibular hypoplasia resulting in facial asymmetry, ear and/or eye malformation, and vertebral anomalies. In addition, renal and gastrointestinal abnormalities were observed in 2 patients. Regarding the oral involvement, 2 patients presented cleft lip and palate, and 1 patient had temporomandibular joint malformation. Malocclusion was found in all patients. CONCLUSION: Our orofacial findings correlate with the reported cases in the literature, and point out that after diagnosis GS patients need to be examined for systemic abnormalities

Effectiveness of low flow vascular lesions sclerosis with monoetanolamine : report of six cases

Vascular malformations or even hemangiomas need therapeutic intervention if they start to cause clinical symptoms or personal discomfort. Different therapeutic modalities, including cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgery, and/or embolization, can be performed successfully. Sclerotherapy with monoethanolamine is a relatively simple and effective method to treat low flow vascular lesions. We presented a report of six cases of vascular malformations treated with monoethanolamine. There were 3 male and 3 female patients, with an age range of 20 to 68 years. The patients were submitted to applications according to clinical response and/or tolerability. In all cases, low-flow vascular lesions were recorded and submitted to infiltration with 2.5% monoethanolamine, directly into the lesions. The volume applied was approximately the middle of affected area. Vascular lesions were characterized as low-flow due to absence of arterial pulsation and flat consistence. The sclerosis with 2.5% monoethanolamine resulted in complete or partial involution, without severe complications

Delay in diagnosis of oral cancer:a systematic review

Oral cancer represents a worldwide public health problem, being among the most prevalent, associated with high morbidity and mortality rates. This systematic review aimed to review the causes of the delayed diagnosis of oral cancer mainly in the elderly, in developed and developing countries. Search strategy was developed for MEDLINE databases (via PubMed), EMBASE, Web of Science, SCOPUS, and LILACS and for grey literature (Google Scholar, ProQuest and OpenGrey), without language or period restrictions. The risk of bias was assessed using instruments from the Joanna Briggs Institute and the quality of evidence according to the GRADE system. The search resulted in 14,473 records, of which only 13 met the eligibility criteria. The total sample was 1,705 participants, with a predominance of males. All studies included reported causes of delayed diagnosis of oral cancer related to the patient and five also reported causes related to health professionals. The scarce knowledge of the population was pointed out as the main cause of delayed diagnosis of this cancer. Regarding the risk of bias, ten studies were classified as low risk and three, as moderate risk. The quality of the evidence was very low for the outcome related to delayed diagnosis of oral cancer. Wide dissemination of information on oral cancer is needed, especially for the elderly, such as its initial signs and symptoms, in developed and developing countries. Further studies should be conducted to better understand the causes of delayed diagnosis of oral cancer in countries with different socioeconomic statuses

Pigmented odontogenic keratocyst : report of a rare case and review of the literature

Pigmented odontogenic keratocyst (OKC) is very rare and its etiology remains uncertain. To the best of our knowledge, only 9 cases of pigmented OKC have been published in English-language literature. This report describes a pigmented OKC in a 14-year-old black male patient. Radiographically, the lesion appeared as a well-circumscribed, unilocular, and radiolucent image. A surgical excision was performed. Histopathological examination revealed an OKC. Additionally, a brownish, sparsed, intracytoplasmic pigmentation was observed in the basal cell layer, which was positive for Fontana-Masson staining. Immunohistochemistry reactions revealed positive dendritic cells for S-100 protein, HMB45 and Melan A. No clinical and imaging signs of recurrence were observed after 24 months. In conclusion, melanin apparently does not represent a factor for distinct biological behavior in OKC