Adenomatoid hyperplasia of minor salivary glands: a report of two cases

Introduction: Adenomatoid hyperplasia of minor salivary glands is a rare benign lesion that can be mistakenly diagnosed as other types of salivary gland neoplasms. It presents as a small firm nodule or as an exophytic mass, usually painless with normal mucosa, and slightly red or blue. Histologically, aggregates of relatively normal acinar lobule mucosa can be seen in larger amounts than expected, causing increased volume and sometimes pain. Case report: This article describes two cases of adenomatoid hyperplasia of minor salivary glands, the first in the left buccal mucosa of a 12 year-old boy and the second in the labial mucosa of a 44 year-old woman, and a review of previous reports of this pathology in English literature. The clinical appearance of the tumor is indistinguishable from salivary gland neoplasms and pathological examination is therefore essential for definitive diagnosis of this pathology. In both cases the treatment chosen after diagnosis was follow up and no changes were observed over 2 years from the first appointment

Epidemiological profile of ameloblastoma at Erasto Gaertner Hospital

Ameloblastoma is the most common benign tumor of odontogenic origin, and represents about 11% of all odontogenic tumors. It is characterized by being locally aggressive and having high recurrence rates. Objective: To evaluate the occurrence of ameloblastoma in the Erasto Gaertner Hospital in patients from 1972 to 2012. In addition, to assess the main treatments, the most prevalent histological variants, the recurrence rate, the anatomical location of the lesion and patient profile. Material and methods: A retrospective study of patients diagnosed with ameloblastoma at the Erasto Gaertner Hospital between the years 1972-2012 was performed. Epidemiological data were collected such as gender, age, race, lesion location, type of surgical procedure, follow-up and recurrence rate; and analyzed using descriptive statistics. Results: A total of 40 patients were selected for the study. The most affected age group was between the third and fifth decade of life, with 19 cases (47.5%), followed by the second and fourth decade, with 14 cases (35%); the sixth decade, with 5 cases (12.5%) and seventh decade with 1 case (2.5%). The patients’ ages ranged from 13 to 66 years, with an average age 34.9 years. The mandible was the most affected site, with 38 cases (95%) of cases, and maxilla had only 2 cases (5%). Thirty-eight patients were treated with radical surgery and 5 patients presented recurrence after 1 year of follow-up. Both cases that occurred in maxilla presented recurrence. Conclusion: Recurrence of ameloblastoma decreases significantly when surgery is performed properly, with wide excision and margin. Combination of full tumor resection and reconstruction was the best approach observed in this study. In addition, we recommend a long period of clinical and radiographic follow-up

Effect of Storage Time and Temperature on Salivary Total Antioxidant Capacity, Total Oxidant Status, and Oxidant Stress Index

Cilj: Cilj ovog istraživanja bio je usporediti utjecaj kratkotrajnog skladištenja sline na dvjema različitim temperaturama na stabilnost ukupnog antioksidacijskog kapaciteta (TAC) i ukupnog oksidacijskog statusa (TOS) te na indeks oksidacijskog stresa (OSI). Materijali i metode: Uzorak sline za ispitivanje prikupljen je od 20 zdravih dobrovoljaca. Alikvot je odabran za trenutačnu analizu, a ostatak je bio pohranjen 120 dana na temperaturama od -20 °C i -80 °C. Analize su obavljene nakon 15, 30, 45, 60, 90 i 120 dana. Određivanje TOS-a i TAC-a provedeno je kolorimetrijskim metodama. Rezultati: Rezultati pokazuju da su se na obje temperature skladištenja mogli očuvati oksidansi i antioksidansi do 60 dana i da su im, u usporedbi sa svježim uzorcima, razine ostale slične. Pri uspoređivanju različitih temperatura skladištenja u svakoj vremenskoj točki, nisu uočene statistički značajne razlike. Naposljetku, OSI je ostao konstantan tijekom skladištenja na objema temperaturama, bez statistički značajnih razlika. Rezultati su izraženi kao srednja vrijednost ± standardna pogreška. Statistička analiza obavljena je analizom varijance (ANOVA) te Bonferronijevim i t-testom. P-vrijednost <0,05 prihvaćena je kao statistički značajna. Zaključak: Obje temperature bile su u stanju održati slične razine TOS-a i TAC-a u uzorcima svježe sline. Zato su pouzdani za procjenu oksidativnog/oksidacijskog stresa do 60 dana.Objective: The aim of this study was to compare the effects of short-term storage in two different temperatures on stability of salivary total antioxidant capacity (TAC), total oxidant status (TOS) and oxidant stress index (OSI). Material and methods: Saliva samples were collected from twenty healthy volunteers for the study. An aliquot was selected for immediate analysis and the rest was stored at -20°C and -80°C for a period of 120 days, and analyzes were performed at 15, 30, 45, 60, 90 and 120 days. The determination of the TOS and the TAC were performed by colorimetric methods. Results: The results show that the two storage temperatures were able to preserve oxidants and antioxidants up to 60 days with similar levels when compared with fresh samples. When comparing the different storage temperatures at each time point, no significant differences were observed. Finally, the OSI remains constant over time of storage at both temperatures without statistically significant differences between them. The results were expressed as mean ± standard error of mean. Statistical analysis was performed using the repeated-measures analysis of variance (ANOVA), the Bonferroni and t-test. A p-value <0.05 was accepted to be statistically significant. Conclusion: The two temperatures were able to keep salivary TOS and TAC levels similar to fresh saliva samples. Therefore they are reliable for assessing oxidative stress up to 60 days

The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil

The aim was to examine the interval since first symptoms until final diagnosis of squamous cell carcinoma (SCC) in the head and neck region in southern Brazil. The individuals were prospectively selected and underwent anamnesis, physical examination and interview in the first medical consultation at a Cancer Hospital from south of Brazil. From 488 patients who underwent clinical examination, 105 were included in the study with diagnosis of SCC. Patients average interval from first symptoms to final diagnosis was 152 days (median 86; max:1105; min: 1), the average professional interval was 108 days (median: 97; max:525; min: 1) , and the average total period interval was 258 days (median: 186; max:1177; min: 45). Factors statistically associated with patient and diagnosis itinerary intervals were smoking and poorly adapted dentures and distance from home to hospital, respectively. The identification of the itinerary characteristics of this specific population may reflect in more effective public policies, such as primary and secondary prevention programs, aiming to increase the survival of oncological patient. Furthermore, the knowledge of the variables that influence the late diagnosis minimizes patient's journey in search of care to cancer centers through health programs

Secondary alveolar bone graft in patients with bilateral cleft lip and palate submitted to premaxilla repositioning: retrospective study

Introduction and Objective: This study aimed to analyze the effectiveness of the closure of oronasal communication, to report the importance of secondary alveolar bone graft repositioning of the premaxilla in patients with bilateral complete cleft lip and palate. Material and methods: This retrospective study analyzed the medical records obtained from the Cleft Lip and Palate Integral Care Center/ Association of Rehabilitation and Social Development of Cleft Lip and Palate Patients (CAIF/AFISSUR), Curitiba – Paraná – Brazil, to obtain statistical data involving 26 records of patients who underwent this surgery in the period between January/2010 – January/2014. Results and Conclusion: The benefits observed were: premaxilla stability, aided by the union of pre-maxillary segments; integrity of oronasal structure; aesthetic improvement; better bone support for the teeth adjacent to the cleft; support for the bridge of the nose reducing facial asymmetry and facilitating future rhinoplasty; orthodontic treatment without the limitation of the bone defect; closure of oronasal communication in 88% of patients

CAN NLR BE A BIOMARKER FOR MUCOSITIS AND GVHD IN PATIENTS UNDERGOING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION?

Allogeneic hematopoietic stem cell transplantation (HSCT) is the treatment for many diseases, however can induce important complications such as Oral Mucositis (OM) and Graft-versus-Host Disease (GVHD). The neutrophil-lymphocyte ratio (NLR) is a peripheral biomarker of systemic inflammation and an independent prognostic factor in several inflammatory diseases. Objective: The aim of this study was to evaluate the association of NLR with OM and GVHD in patients undergoing allogeneic HSCT. Methods: Patients who underwent&nbsp; allogeneic HSCT at the Bone Marrow Transplant Service at the Hospital de Clínicas Complex of the Federal University of Paraná were included in the study. Sociodemographic data and blood count were collected from patients' medical records. NLR was calculated and associated with OM and GVHD. Results: 45 patients were included in the study. NLR was considerably higher in patients who had OM and oral GVHD when compared to patients who did not present these conditions, nonetheless no statistically significant difference was observed. Conclusion: Although both OM and GVHD are associated with inflammatory response as well as to the immune system, it was not associated with NLR. A further investigation considering other variables related to the HSCT might find possible association as it could favor patients management and prevention

Implantes dentários em pacientes usuários de bifosfonatos: o risco de osteonecrose e perda dos implantes é real? Relato de três casos clínicos Dental implants in patients under bisphosphonate therapy: is the risk of osteonecrosis of the jaw and implant loss real? Report of three clinical cases

Introdução: A osteonecrose induzida por medicamentos (ONIM) é uma grave complicação da terapia com drogas antirreabsortivas, como os bifosfonatos (BFs). Embora ocorra com mais frequência em pacientes oncológicos, os quais utilizam BFs endovenosos, pacientes usuários de BFs orais para tratamento de osteoporose também se encontram no grupo de risco, principalmente quando procedimentos odontológicos cirúrgicos como exodontias e implantes dentários são realizados. Objetivo: Relatar três casos de pacientes que fizeram usode BFs no passado ou ainda utilizavam a medicação durante cirurgia para instalação de implantes dentários, abordando os principais fatores de risco para o desenvolvimento da ONIM. Conclusão: O conhecimento prévio pelo implantodontista dos efeitos adversos da terapia com drogas antirreabsortivas em pacientes que necessitam de reabilitação dentária é de extrema importância no manejo desses pacientes, uma vez que elas podem prejudicar a longevidade das reabilitações com implantes e induzir à osteonecrose dos maxilares,comprometendo não somente a saúde bucal como também interferindo negativamente na qualidade de vida dos pacientes.Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of therapies with anti-resorptive drugs, such as bisphosphonates (BFs). Although it occurs more often in oncology patients who use intravenous BFs, patients who use oral BFs for osteoporosis are also in the risk group, especially when surgical dental procedures such as dental extraction or dental implants are performed. Objective: To report three cases of patients who were submitted to BF therapy in the past or were still using the medication during dental implants surgery and developed BRONJ and lost the implants. Conclusion: It is extremely important that the dentists are aware of the adverse effects of BF therapy in patients that require dental rehabilitation for the management thereof, since they can reduce the longevity of dental implants and induce osteonecrosis of the jaw, compromising not only their oral health but also these patients’ quality of life.Introdução: A osteonecrose induzida por medicamentos (ONIM) é uma grave complicação da terapia com drogas antirreabsortivas, como os bifosfonatos (BFs). Embora ocorra com mais frequência em pacientes oncológicos, os quais utilizam BFs endovenosos, pacientes usuários de BFs orais para tratamento de osteoporose também se encontram no grupo de risco, principalmente quando procedimentos odontológicos cirúrgicos como exodontias e implantes dentários são realizados. Objetivo: Relatar três casos de pacientes que fizeram usode BFs no passado ou ainda utilizavam a medicação durante cirurgia para instalação de implantes dentários, abordando os principais fatores de risco para o desenvolvimento da ONIM. Conclusão: O conhecimento prévio pelo implantodontista dos efeitos adversos da terapia com drogas antirreabsortivas em pacientes que necessitam de reabilitação dentária é de extrema importância no manejo desses pacientes, uma vez que elas podem prejudicar a longevidade das reabilitações com implantes e induzir à osteonecrose dos maxilares,comprometendo não somente a saúde bucal como também interferindo negativamente na qualidade de vida dos pacientes.Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of therapies with anti-resorptive drugs, such as bisphosphonates (BFs). Although it occurs more often in oncology patients who use intravenous BFs, patients who use oral BFs for osteoporosis are also in the risk group, especially when surgical dental procedures such as dental extraction or dental implants are performed. Objective: To report three cases of patients who were submitted to BF therapy in the past or were still using the medication during dental implants surgery and developed BRONJ and lost the implants. Conclusion: It is extremely important that the dentists are aware of the adverse effects of BF therapy in patients that require dental rehabilitation for the management thereof, since they can reduce the longevity of dental implants and induce osteonecrosis of the jaw, compromising not only their oral health but also these patients’ quality of life

Reabilitação bucal em ambiente hospitalar em paciente com Disceratose Congênita e Doença Periodontal Generalizada: relato de caso

A Disceratose Congênita (DC) é uma genodermatose genética rara com predileção pelo sexo masculino onde o paciente diagnosticado com a doença pode desenvolver alterações em diversos órgãos. A doença caracteriza-se por uma tríade patognômonica que facilita o diagnóstico final da doença, a qual é composta por pigmentação reticular da pele, distrofia ungueal e leucoplasias bucais. Pacientes com DC desenvolvem falência medular associada a manutenção anormal dos telômeros, sendo o Transplante de Células-Tronco Hematopoiéticas (TCTH) alogênico a única possibilidade de cura. Além das placas brancas orais características da doença, o paciente com DC pode apresentar outras manifestações bucais, como, por exemplo, a doença periodontal. As leucoplasias orais devem receber maior atenção por apresentarem potencial de malignização. O objetivo deste trabalho é relatar o caso de um paciente do sexo masculino, com 23 anos de idade, diagnosticado com DC, que após estabelecimento de doença periodontal severa, necessitou da exodontia de todos os dentes e posterior reabilitação protética bucal, realizada em ambiente hospitalar. A confecção de próteses totais não é rotineira em ambiente hospitalar, assim, esse caso torna-se relevante por relatar a reabilitação bucal em paciente jovem com doença sistêmica rara. A reabilitação protética possibilitou o restabelecimento da estética, função e autoestima do paciente, interferindo significativamente em sua qualidade de vida e reintegração social e familiar