Factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment of head and neck cancer

Facial disfigurement has been considered one of the most challenging consequences of the surgical treatment for head and neck cancer patients, mainly due to the importance of the facial region for the personal identity, body self-image and interpersonal interactions, which might affect negatively the quality of life. The aim of this study was to assess factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment. Clinical data were retrieved from 103 patient?s medical records and quality of life data were collected using the Functional Assessment of Cancer Therapy (FACT-H&N) questionnaire. Moreover, the degree of facial disfigurement was classified by means of a specific ordinal scale. Data from the FACT-H&N questionnaire showed that the domain directly related to head and neck symptoms was considered the most impacted, while emotional domain was the least affected. Lower quality of life was associated with sequels in the neck and/or lower third of the face (?=-0.39; p=0.001), a higher level of disfigurement (?=-0.29; p=0.016) and female gender (?=-0.20; p=0.038). Disfigurement due to surgical treatment was significantly associated with the functional dimension of the patients, especially in extensive sequels in the cervical and lower regions of the face

Traumatic neuroma of the mandible: a case report with spontaneous remission

Traumatic neuroma is a well-known disorder involving peripheral nerves, which occurs following trauma or sur - gery. The lesion develops most commonly in the soft tissues of the mental foramen area, lower lip and tongue. Intra- osseous lesions arising in jawbones are very uncommon. In this paper, we report a new case of an intra-osseous traumatic neuroma, discovered incidentally on a panoramic radiograph obtained for orthodontic documentation. In addition, the case herein described developed spontaneous remission, a situation not previously reported in the literature. Finally, we discuss relevant demographic, clinical, microscopic, immunohistochemical and treatment aspects of traumatic neuromas

Endodontic material diffusion in the pathogenesis of maxillary sinus aspergillosis

One undesirable sequela of root canal treatment is the overextension of endodontic material into the maxillary sinus, which may represent a risk factor for maxillary sinus aspergillosis (MSA). Diverse clinical presentations of aspergillosis have been reported and they vary depending on the immune status of the host. The noninvasive form called Aspergillus mycetoma occurs mostly in healthy people. This report describes a case of MSA associated with root canal overfilling in a 27-year-old healthy man. The patient had been asymptomatic for 6 years after root canal treatment. Radiography revealed a diffuse radiopaque mass inside the left maxillary sinus, with radiolucent areas near the cortical bone of the maxillary sinus. Computed tomography (CT) showed the presence of material with a density similar to that of soft tissue. Imaging findings suggested that the calcification filled the left maxillary antrum, without expansion or bone destruction. The lesion was removed, and microscopic examination of the specimen revealed an inflammatory process with numerous dichotomized fungal structures (compatible with Aspergillus sp.). Histopathological features were compatible with aspergillosis. Treatment consisted of surgery and adjunctive anti-fungal therapy with itraconazole. Clinical and radiographic follow-up revealed no recurrence of the lesion

Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus

Objective: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT). Study Design: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. Results: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). Conclusion: CBCT scanning detect MRCMS more accurately than panoramic radiography

Chondroblastic osteosarcoma mimicking periapical abscess

Lesions of non-endodontic origin may mimic periapical abscess. Osteosarcoma is a rare malignant lesion. Case report The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed. Conclusions Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess

Clinicopathologic data of individuals with oral lichen planus : a Brazilian case series

The aim of the present series was to analyze the sociodemographic characteristics, clinicopathologic features, and oral health-related quality of life of 41 individuals with oral lichen planus (OLP). In a retrospective analysis (1998-2018), individuals with a clinical diagnosis of OLP from a referral service of Oral Medicine of Brazil were invited for follow-up. The individuals were assessed using the Oral Health Impact Profile-14 (OHIP-14) form. Histopathological data were reviewed according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016). This series mainly consisted of females (70.7%) in their forties (31.7%). The buccal mucosa (68.2%) was the most commonly affected site. Reticular (56.1%) and erosive (34.3%) appearances were the most frequent. According to OHIP-14, individuals with OLP at multiple sites in the oral cavity showed worse values in the handicap domain and those who did not respond to corticosteroids showed a higher score on the psychological discomfort domain. The findings of the present study, using the AAOMP/2016 criteria, agree with case series and retrospective studies reported in the literature. Besides, OLP in its more severe clinical forms had an influence on patient quality of life

Effects of a mucoadhesive formulation containing curcuma longa l. on oral wound healing

Introduction: The aim of this study was to investigate the effects of a topical mucoadhesive formulation with Curcuma longa L. extract (MFC) on oral wound healing. Methods: Seventy-two Wistar rats were randomly assigned to 3 groups: Control, Vehicle, and MFC. Traumatic ulcers were made on the dorsum of the tongue with a 3-mm diameter punch. Vehicle and MFC groups received application of the products twice a day, while animals in the control group were cared for in identical conditions but received no product application. Six rats in each group were euthanized at days 3, 5, 10, and 14. Percentage of repair was calculated based on wound area. HE-stained histological sections were obtained for semi-quantitative analysis of re-epithelization and inflammation. Results: Clinical findings revealed that at days 3 and 5, animals from the MFC group exhibited a significantly higher percentage of wound repair. At day 5, animals from this group also demonstrated a significant increase in the degree of re-epithelization and inflammation. Conclusions: MFC is capable of accelerating oral wound repair in an in vivo model by modulating the inflammatory process and stimulating epithelial proliferation

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region

Acinic cell carcinoma of the oral and maxillofacial region : an international multicenter study

The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.The Brazilian National Council for Scientific and Technological Development (CNPq), the Coordination for the Improvement of Higher Education Personnel (CAPES) and the CNPq.https://www.scielo.br/j/boram2024Oral Pathology and Oral BiologySDG-03:Good heatlh and well-bein