Ameloblastomas mimicking apical periodontitis:a case series

Ameloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological and histological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-year period. all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting a clinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological and histological characteristics from all cases were tabulated and descriptively and comparatively analyzed. Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age of the affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%) image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common. Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adult males as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture

Geographic stomatitis : an enigmatic condition with multiple clinical presentations

Geographic stomatitis is an uncommon inflammatory condition of unknown etiology. It is characterized by reddish areas surrounded by white borders affecting any location in the oral cavity and presenting a migratory and cyclic pattern. The most common affected sites include buccal mucosa, labial mucosa and mucobuccal fold. Some patients can complain of pain or burning sensation. There are few reports in the literature about this entity and its relationship with other oral and cutaneous conditions such as fissured tongue, Reiter?s syndrome, atopy and psoriasis has been suggested but it is still controversial. In the present study we describe three cases of geographic stomatitis associated with fissured tongue. Lesions involved the buccal mucosa, labial mucosa, soft palate and mucobuccal fold and all cases were diagnosed based on their clinical features. All patients were oriented about the innocuous behavior of the condition and were advised to avoid exposure of the lesions to irritation factors. The three presented cases highlighted the importance of a detailed oral mucosal examination by clinicians and provided further information about the natural history and clinical presentation of geographic stomatitis

Estomatite de contato a creme dental: importância do diagnóstico diferencial

Objective: the aim of the present study is to report four cases of toothpaste-related contact stomatitis focusing on their clinical presentation and the importance of differential diagnosis with other reactive, inflammatory and potentially malignant disorders of the oral cavity. Case report: the four cases affected adult females and presented as multifocal whitish and/or erythematous patches and plaques affecting the tongue, floor of mouth, and labial mucosa, showing mild burning sensation, and lasting 7 to 15 days. All patients reported starting the use of new toothpastes few days before the onset of the symptoms and all lesions disappeared in 5 to 7 days after suspension of its use. Conclusion: contact stomatitis to toothpastes should be considered in the differential diagnosis of oral white and red patches and plaques, and detailed clinical history is essential for prompt and correct final diagnosis. As the use of new oral rinses, toothpastes and other oral hygiene products is increasing, clinicians should be aware of the possibility of oral local reactions associated with their use.Objetivo: o objetivo do presente trabalho é relatar 4 casos de estomatite de contato relacionada a cremes dentais com foco em sua apresentação clínica e a importância do diagnóstico diferencial com outras condições reativas, inflamatórias e potencialmente malignas da cavidade oral. Relato de caso: os 4 casos envolveram mulheres adultas e apresentaram-se clinicamente como manchas e placas brancas e vermelhas multifocais acometendo a língua, o assoalho de boca e a mucosa labial, associadas a discreta sensação de queimação e com evolução de 7 a 15 dias. Todas as pacientes relataram terem iniciado o uso de um novo creme dental poucos dias antes do surgimento dos sintomas e todas as lesões desapareceram em um intervalo de 5 a 7 dias após a suspensão do seu uso. Conclusão: estomatite de contato relacionada a cremes dentais deve ser considerada no diagnóstico diferencial das manchas e placas brancas e vermelhas da cavidade oral, e a história clínica detalhada é essencial para o diagnóstico final correto e precoce. Como o uso de novos enxaguatórios e cremes dentais, assim como de outros produtos de higiene oral, vem aumentando, dentistas clínicos devem estar atentos a possibilidade de reações locais orais associadas ao seu uso

Características clínico-patológicas do líquen plano bucal em pacientes diagnosticados em um único serviço de Medicina Oral no Brasil: um estudo descritivo

Lichen planusis a T-cell mediated mucocutaneous disease of um known etiology. Know ledgeon epidemiological data from the disease isimportantto preventand to establish therapeutics trategies. Objective: the aim of this study was to review cases diagnosed as oral lichen planus in a Stomatology service. Material and method: all cases diagnosed as oral lichen planus were reviewed and epidemiological data were obtained from the patients records. Demographic and clinical data were described, including gender, age, symptoms, time of evolution, medical history, habits, location and clinical aspect of the lesions. Clinical and histological analysis was performed using van der Waal´s parameters (van der Waal, 2009). Cases with incomplete data and without final conclusive diagnosis were excluded. Results: sixteen cases composed the final sample through both clinical and histological criteria. Females were more affected (94%) and mean age of the patients was 55 years-old (ranging from 24 to 82 years-old). The most common site of involvement was buccal mucosa.Most lesions (69%) were clinically described as white bilateral symmetric striae with erithematous areas. Most patients (75%) complained about burning symptoms. Medical history revealed 44% of the patients with hypertension, 12% of the patients with diabetes and 19% of the patients with hypothyroidism and 6% with hyperthyroidism. Six percent of the patients were smokers. Conclusion: oral lichen planus affected more middle age females with discrete signs and symptoms.Objetivo: o objetivo deste estudo foi revisar todos os casos diagnosticados como líquen plano bucal em um período de 11 anos em um serviço de estomatologia. Material e Métodos: todos os casos diagnosticados como líquen plano bucal foram revisados ??e dados epidemiológicos foram obtidos dos prontuários dos pacientes. Dados demográficos e clínicos foram descritos, incluindo sexo, idade, sintomas, histórico médico, hábitos, localização e aspecto clínico das lesões. A análise clínica e histológica foi realizada com o uso de van der Waal critérios (van der Waal, 2009). Casos com dados incompletos e sem diagnóstico conclusivo final foram excluídos. Resultados: dezesseis casos compuseram a amostra final através de critérios clínicos e histológicos. As mulheres foram mais afetadas (94%) e a média de idade dos pacientes foi de 55 anos (variando de 24 a 82 anos). O local mais comum de envolvimento foi a mucosa bucal. A maioria das lesões (69%) foi descrita clinicamente como estrias simétricas bilaterais brancas com áreas eritematosas. A maioria pacientes (75%) queixaram-se de sintomas de queimação. A história médica revelou 44% dos pacientes com hipertensão arterial, 12% dos pacientes com diabetes e 25% dos pacientes com disfunção tireoidiana. Conclusões: o LPO afetou principalmente as fêmeas adultas e as lesões afetaram preferencialmente a mucosa bucal, língua e gengiva mucosa alveolar. A maioria dos pacientes apresentava outras comorbidades médicas, mas sua associação com o LPO deveria ser mais investigada

Fibroma ossificante periférico de grandes dimensões simulando clinicamente uma neoplasia maligna

Objective: the aim of the present paper is to report a large peripheral ossifying fibroma (POF) clinically mimicking a malignant neoplasm. Case report: a 35 yearold female was referred for evaluation of a 6,0 x 4,0 cm reddish partially ulcerated and bleeding exophytic swelling situated in the upper left gingiva and alveolar mucosa, lasting 3 months. Panoramic and occlusal radiographs showed no alterations and computed tomograph scans showed the presence of calcified foci inside the lesion. Clinical diagnosis was peripheral ossifying fibroma and bone-producing neoplasms, including osteosarcoma. An incisional biopsy under local anesthesia was performed and the 5 ?m HE-stained sections revealed a homogeneous proliferation of spindle cells associated with areas of calcified tissue and covered by partially-ulcerated surface epithelium. Conservative complete surgical removal of the lesion was performed and analysis of the surgical specimen confirmed the histological features from the initial biopsy and the diagnosis of peripheral ossifying fibroma. Clinical follow-up showed the area totally repaired and no evidence of local recurrence. Conclusion: malignant neoplasms can be eventually included in the differential diagnosis of oral reactive inflammatory conditions and histological analysis is essential for proper diagnosis and management.Objetivo: O objetivo do presente trabalho é relatar um fibroma ossificante periférico de grandes dimensões simulando clinicamente uma neoplasia maligna. Relato de caso: paciente de 35 anos, sexo feminino, foi encaminhada para avaliação de lesão exofítica, medindo 6,0 x 4,0 cm parcialmente ulcerada, avermelhada e sangrante, localizada na gengiva e mucosa alveolar superior a esquerda, com duração de 3 meses. Radiografias panorâmica e oclusal superior não mostraram alterações significativas e na tomografia computadorizada foram observadas calcificações no interior da lesão. O diagnóstico clínico incluiu Fibroma ossificante periférico e neoplasias produtoras de tecido mineralizado, incluindo osteossarcoma. Foi realizada biópsia incisional sob anestesia local e cortes de 5 µm corados com hematoxilina e eosina evidenciaram uma proliferação homogênea de células fusiformes associadas a áreas focais de calcificação coberta por epitélio de superfície parcialmente ulcerado. A remoção cirúrgica total da lesão realizada de forma conservadora sob anestesia local confirmou os achados histológicos encontrados no espécime da biopsia incisional e o diagnóstico de fibroma ossificante periférico. O controle clínico pós-cirúrgico mostrou a área totalmente cicatrizada e sem evidências de recidiva. Conclusão: neoplasias malignas podem eventualmente ser incluídas no diagnóstico diferencial clínico e imaginológico de condições inflamatórias reativas da cavidade oral e a avaliação histológica é mandatória para a confirmação diagnóstica