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INTRODUCTION: Idiopathic bone cavity (IBC) is an uncommon bone lesion that usually affects youngsters as an unilocular radiolucency with predilection for the posterior mandible. Because the lesion is frequently located in proximity to the adjacent teeth, chronic apical periodontitis is commonly included as a differential diagnosis. The aim of the present study was to analyze the clinical and radiologic features of a series of IBCs diagnosed in a single service. METHODS: All cases diagnosed as IBC were retrieved from the files of an oral pathology laboratory, and the clinical and radiologic characteristics were described with a focus on the differential diagnosis with chronic apical periodontitis. RESULTS: Thirty cases composed the final sample. The mean age of the affected patients was 22 years old; there was no sex predilection, and most lesions were located on the posterior (47%) and anterior (43%) mandible. Most lesions presented as unilocular radiolucencies (87%), and 90% were located in close association with the adjacent teeth. The associated teeth presented no endodontic involvement, and all proved to be vital. CONCLUSIONS: IBC usually affects young patients as an unilocular radiolucency in close association with the adjacent teeth. Careful radiologic analysis and vitality tests of the adjacent teeth are essential to rule out chronic apical periodontitis, thus avoiding any unnecessary endodontic treatment.
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Periodontite Periapical , Periodontite , Adulto , Diagnóstico Diferencial , Humanos , Mandíbula , Periodontite Periapical/diagnóstico por imagem , Adulto JovemRESUMO
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. Key words:Geographic stomatitis, geographic mucositis, geographic tongue.
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The present study reports two cases of oral perineuriomas, including a clinicopathologic review of the 39 published cases (17 intraneural and 22 extraneural perineuriomas) in the English language literature. In the first case, the tumor occurred in an 84-year-old male as a painless, asymptomatic, 20-mm submucosal nodule on the right lower mucobuccal fold near to the premolar area. In the second case, a 46-year-old female presented with a painless, 25-mm, slow-growing, fibrous, pedunculated nodule on the right buccal mucosa. In the first case, the tumor was composed of spindle cells arranged in a storiform pattern, classified as intraneural perineurioma; and in the second, it was an extraneural perineurioma, showing a whorled myxoid stroma. Immunohistochemical analysis confirmed the diagnosis by showing positivity for vimentin, EMA, and Glut-1 in case 1 and EMA, Glut-1, Claudin-1, and CD34 (focally) in case 2. Complete surgical removal was performed for both tumors, and there was no evidence of local recurrence after a long-term follow-up.
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Mucosa Bucal/patologia , Neoplasias Bucais/patologia , Neoplasias de Bainha Neural/patologia , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/cirurgia , Neoplasias de Bainha Neural/cirurgiaRESUMO
Objetivo: o objetivo deste trabalho é relatar quatro casos de reações de corpo estranho a material de preenchimento estético acometendo a cavidade oral. Relato dos casos: quatro pacientes adultas do sexo feminino compareceram à consulta apresentando nódulos submucosos localizados nos lábios e sulcos nasogenianos com histórico prévio de injeção de materiais de preenchimento estético (ácido hialurônico em duas pacientes e polimetilmetacrilato em duas pacientes). O diagnóstico em três dos quatro casos foi baseado nos achados clínicos e histológicos e apenas nos achados clínicos em um caso. O tratamento consistiu de manejo cirúrgico em três pacientes e corticoterapia em uma paciente e todas se encontram bem e em acompanhamento clínico. Conclusão: os cirurgiões-dentistas devem estar atentos aos efeitos adversos provocados por materiais de preenchimento estético, considerando seus diagnósticos diferenciais e as formas mais adequadas de tratamento.
Objective: The aim of the present study is to report 4 cases of foreign body reactions to dermal fillers affecting the oral cavity. Cases report: Four adult females were referred for evaluation of submerse nodules on the lips and nasolabial folds with a previous history of injection of dermal fillers (hyaluronic acid in two cases and polymethylmethacrylate in two cases). Diagnosis was based on clinical and histological aspects in three cases and solely on clinical aspect in one case. Management consisted in surgical excision in three cases and corticosteroid therapy in one and all 4 patients are well, with no signs of recurrence and remain in clinical follow-up. Conclusion: Dental professionals should be aware of the side effects associated with the use of aesthetic fillers, considering their main differential diagnosis and the most adequate management strategy for each individual case.
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The aim of this study was to report the frequency and clinical-radiological features of cases of lingual cortical mandibular bone depressions (LCMBD) diagnosed in consecutive panoramic radiographs and cone-beam computed tomography (CBCT) scans from a Brazilian population. The methods included a retrospective analysis of consecutive panoramic radiographs, charts from the Oral Medicine clinic and consecutive CBCT scans. All cases diagnosed as LCMBD were selected and clinical-radiological data were retrieved from the clinical charts and by the analysis of the image exams. Twenty LCMBD cases diagnosed in 18 patients were found, including 2 from 3,000 consecutive panoramic radiographs (0.07%), 6 from 2,421 Oral Medicine patients (0.25%) and 10 from 1,684 CBCT scans (0.59%). The 18 patients had a mean age of 51.5 years and 13 were males. Two patients presented bilateral lesions. Fourteen images (70%) were classified as well-defined. Eighteen affected the posterior area of the mandible and two affected the anterior mandible. Size of the lesions was larger in younger patients. In conclusion, there seemed to be a considerable radiological heterogeneity when comparing the LCMBD cases and it seemed that the images decreased in size with the increase of patient's age.
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Cistos Maxilomandibulares/epidemiologia , Doenças Mandibulares/epidemiologia , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Feminino , Humanos , Incidência , Cistos Maxilomandibulares/diagnóstico por imagem , Masculino , Doenças Mandibulares/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia Panorâmica/estatística & dados numéricos , Estudos Retrospectivos , Adulto JovemRESUMO
The aim of this study was to report the frequency and clinical-radiological features of cases of lingual cortical mandibular bone depressions (LCMBD) diagnosed in consecutive panoramic radiographs and cone-beam computed tomography (CBCT) scans from a Brazilian population. The methods included a retrospective analysis of consecutive panoramic radiographs, charts from the Oral Medicine clinic and consecutive CBCT scans. All cases diagnosed as LCMBD were selected and clinical-radiological data were retrieved from the clinical charts and by the analysis of the image exams. Twenty LCMBD cases diagnosed in 18 patients were found, including 2 from 3,000 consecutive panoramic radiographs (0.07%), 6 from 2,421 Oral Medicine patients (0.25%) and 10 from 1,684 CBCT scans (0.59%). The 18 patients had a mean age of 51.5 years and 13 were males. Two patients presented bilateral lesions. Fourteen images (70%) were classified as well-defined. Eighteen affected the posterior area of the mandible and two affected the anterior mandible. Size of the lesions was larger in younger patients. In conclusion, there seemed to be a considerable radiological heterogeneity when comparing the LCMBD cases and it seemed that the images decreased in size with the increase of patient's age.
Resumo O objetivo deste estudo foi relatar a frequência e os achados clínico-radiográficos dos casos de depressão cortical mandibular lingual diagnosticados em radiografias panorâmicas e em tomografias computadorizadas realizadas pela técnica de feixe cônico consecutivas em uma população brasileira. A metodologia incluiu uma análise retrospectiva de radiografias panorâmicas consecutivas, dos registros dos pacientes da clínica de estomatologia e tomografias computadorizadas consecutivas realizadas pela técnica do feixe cônico. Todos os casos com diagnóstico de depressão cortical mandibular lingual foram selecionados e as informações clínico-radiográficas foram obtidas a partir dos prontuários dos pacientes e da análise dos exames imaginológicos. Um total de 20 casos de depressão cortical mandibular lingual foi diagnosticado em 18 pacientes, incluindo 2 casos em 3.000 radiografias panorâmicas (0,07%), 6 em 2.421 pacientes da clínica de Estomatologia (0,25%) e 10 em 1.684 pacientes do grupo submetido a tomografia computadorizada (0,59%). Os 18 pacientes mostraram uma média de idade de 51,5 anos e 13 eram do gênero masculino. Dois pacientes apresentaram imagens bilaterais. Quatorze imagens (70%) foram classificadas como bem definidas; dezoito acometeram a região posterior da mandíbula e dois casos acometeram a região anterior da mandíbula. O tamanho das lesões foi maior em pacientes mais jovens. Em conclusão, existe uma considerável heterogeneidade na expressão radiográfica das imagens e parece haver uma diminuição do tamanho das imagens com o aumento da idade dos pacientes. .
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Cistos Maxilomandibulares/epidemiologia , Doenças Mandibulares/epidemiologia , Fatores Etários , Brasil/epidemiologia , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Incidência , Cistos Maxilomandibulares , Doenças Mandibulares , Estudos Retrospectivos , Radiografia Panorâmica/estatística & dados numéricosRESUMO
OBJECTIVE: The aim of this study was to report the clinicopathologic and radiologic features of 143 benign fibro-osseous lesions (BFOLs). STUDY DESIGN: Clinical and radiologic information were retrieved from the patients files, and histologic features were reviewed from hematoxylin and eosin-stained histologic slides. RESULTS: There were 22 ossifying fibromas (OFs), 21 fibrous dysplasias (FDs) and 100 osseous dysplasias (ODs; 65 florid, 18 focal, and 17 periapical). The mean age of the FD/OF patients was a decade lower than those with OD. The mandible was more affected than the maxilla, except in FDs. All FDs and OFs presented local swelling, whereas this was observed in <40% of the ODs. Radiologic images of the florid/periapical ODs and OFs were predominantly mixed, whereas FDs and focal ODs were predominantly radiopaque. CONCLUSIONS: Florid OD, OF, and FD were the most common diagnoses, and the clinicopathologic and radiologic features were somewhat distinct from the characteristics of other populations.
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Doenças Maxilomandibulares/epidemiologia , Neoplasias Maxilomandibulares/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Cementoma/epidemiologia , Criança , Feminino , Fibroma Ossificante/epidemiologia , Displasia Fibrosa Óssea/epidemiologia , Seguimentos , Humanos , Masculino , Doenças Mandibulares/epidemiologia , Neoplasias Mandibulares/epidemiologia , Doenças Maxilares/epidemiologia , Neoplasias Maxilares/epidemiologia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/estatística & dados numéricos , Estudos Retrospectivos , Adulto JovemRESUMO
The aim of this report was to present a case of endodontic sealer extrusion into the mandibular canal in a 42-year-old woman. The patient was referred to the Endodontology and Stomatology Clinics, School of Dentistry, Estácio de Sá University, complaining of 5-day duration intense spontaneous pain and paraesthesia, both arising after an endodontic intervention. Conventional radiographs and computed tomography of the mandible showed the presence of radiopacities inside the right mandibular canal. History and these radiographs confirmed extrusion of endodontic sealer. Treatment included an anti-inflammatory drug, completion of endodontic treatment and follow up. The patient reported gradual improvement, becoming asymptomatic after 2 months. Radiographs 30 months after initial examination revealed partial resorption of the foreign material. In conclusion, iatrogenic extrusion of endodontic materials should be included in differential diagnosis of endodontic pain and can sometimes be managed through non-surgical interventions in some cases.
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Corpos Estranhos/terapia , Mandíbula , Manejo da Dor , Parestesia/terapia , Materiais Restauradores do Canal Radicular/efeitos adversos , Adulto , Anti-Inflamatórios/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Feminino , Seguimentos , Corpos Estranhos/etiologia , Guta-Percha/efeitos adversos , Humanos , Doença Iatrogênica , Dor/etiologia , Parestesia/etiologia , Radiografia Interproximal , Radiografia Panorâmica , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal RadicularRESUMO
Muitos medicamentos têm o potencial de induzir alterações e sequelas na cavidade oral, e no sistema muscular e esquelético. Por essa razão, torna-se crucial que todo profissional de saúde tenha conhecimento dos possíveis efeitos indesejáveis causados por drogas utilizadas com ou sem prescrição médica, possibilitando o correto diagnóstico e a conduta clínica adequada. O presente trabalho tem como objetivo revisar e listar medicamentos e suas reações adversas com enfoque na cavidade oral.
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Boca , Arcada Osseodentária , Preparações Farmacêuticas/efeitos adversosRESUMO
OBJECTIVE: The objective of this study was to compare the clinicopathological features of oral sebaceous hyperplasia and sebaceous adenoma. STUDY DESIGN: Clinical data, microscopical characteristics, and ki-67 immunoexpression were comparatively analyzed on 2 intraoral sebaceous adenomas, 6 intraoral sebaceous hyperplasias, and 21 normal intraoral sebaceous glands. RESULTS: Clinically, sebaceous glands presented as multiple separated papules, sebaceous hyperplasias as a single enlarged papule, and sebaceous adenoma as a well-defined nodule. Microscopically, sebaceous adenoma presented an increased number of lobules, smaller lobules, and a greater number of germinative/squamous cells. Sebaceous hyperplasia also had an increased number of lobules and fewer number of germinative/squamous cells, as compared to normal oral sebaceous glands. Ki-67 expression was seen only in germinative cells and counts were higher in sebaceous adenomas followed by hyperplasias and normal glands. CONCLUSIONS: Sebaceous hyperplasias and adenomas showed different clinical, microscopic, and proliferative characteristics, suggesting the usefulness of the studied criteria on diagnosis of these uncommon oral lesions.