Dental management long term follow-up of the post radio-chemotherapy-Rhabdomyosarcoma patient: Report of a case

Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma of childhood and adolescence involving the head and neck. It occurs most often in the head and neck region, genitourinary tract, retroperitoneum and the extremities. The current treatment of a combination of surgery, chemotherapy and radiotherapy has dramatically improved the long term survival rates over the last 20 years. However, some of the side effects of post-radiation include delayed eruption of teeth, retarded tooth and bone development, dwarfed teeth, partial anadontia, osteoradionecrosis, xerostomia, mucositis, candidiasis, trismus, loss of taste, soft tissue necrosis, and scar tissue formation. RMS is a comparatively rare lesion for the maxillofacial surgeons. Although documented to be the most common soft tissue sarcoma in children under 15 years of age, there is, however, a paucity of reports on the pattern of the late effects of multimodal treatment results about intra-oral involvement. This case report focused on the dental treatment and facial abnormalities in a long-term survivor of pediatric head and neck RMS patient and review of the literature. © 2012

Primary malignant melanoma

Malignant melanomas (MM) of the oral cavity are extremely rare, accounting for 0.2% to 8.0% of all malignant melanomas. Malignant melanomas is more frequently seen at the level of the hard palate and gingiva. Early diagnosis and treatment are important for reducing morbidity. Malignant melanoma cells stain positively with antibodies to human melanoma black 45, S-100 protein, and vimentin; therefore, immunohistochemistry can play an important role in evaluating the depth of invasion and the location of metastases. A 76-year-old man developed an oral malignant melanoma, which was originally diagnosed as a bluish reactive denture hyperplasia caused by an ill-fitting lower denture. The tumor was removed surgically, and histopathological examination revealed a nodular-type MM. There was no evidence of recurrence over a 4-year follow-up period. © 2016, Saudi Arabian Armed Forces Hospital. All rights reserved

Clinical comparison of submucosal injection of dexamethasone and triamcinolone acetonide on postoperative discomfort after third molar surgery

Objective: The aim of the study was to compare the effect of submucosal injection of dexamethasone and triamcinolone acetonide on postoperative pain, swelling, and trismus occurring after impacted mandibular third molar surgery. Method and Materials: A total of 78 patients (aged 18 to 35) with asymptomatic, unilateral, impacted mandibular third molar, and without any systemic disease were included in this study. Patients were divided into three groups randomly (control, dexamethasone, and triamcinolone acetonide). In the experimental groups, dexamethasone and triamcinolone acetonide were injected into submucosa at about 1 cm above the surgical area submucosally. The control group of patients did not take any drug submucosally but the same surgical procedure was applied. Pain evaluation was performed by visual analog scale (VAS). Swelling was measured using a flexible standard ruler measuring the dimensions of the axes between certain points on the face. For trismus evaluation, maximum mouth opening was measured. Measurements taken on the preoperative, and on postoperative first, third, and seventh days were compared with each other and statistically evaluated. Results: There were statistically significant differences between the control and experimental groups on the different days of the postoperative period. The effect of triamcinolone acetonide on pain started on the first day postoperatively and the effect of triamcinolone acetonide on trismus and pain was better than other groups at the third and seventh days. However, there was no statistically significant difference between the effects of dexamethasone and triamcinolone acetonide regarding postoperative complications. Conclusion: The submucosal injection of dexamethasone or triamcinolone acetonide might be an effective treatment for postoperative discomfort occurring following impacted mandibular third molar surgery, and triamcinolone acetonide could be applied as an alternative to dexamethasone. © Quintessenz