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Int. j. odontostomatol. (Print) ; 13(4): 433-436, dic. 2019. graf
Article in English | LILACS | ID: biblio-1056480


ABSTRACT: Periapical cyst originates from an inflammatory reaction in the body that occurs due to a long-term endodontic aggression. It is more prevalent in caucasian male, during the third decade of life, in the anterior portion of the maxilla. They are commonly radiographic findings, due to their asymptomatic aspect. This study reports a Periapical Cyst in the portion corresponding to teeth 21, 22 and 23, which was treated by enucleation of the cyst, apicoectomy and retrograde root filling with Mineral trioxide aggregate (M.T.A) of teeth 21 and 22, filling of the cyst cavity with xenogeneic bone graft GenOx and a collagen membrane Gen-Derm. Observations after three months show good and rapid bone regeneration, periodontal and periapical health of the teeth involved.

RESUMEN: El quiste periapical se origina de una reacción inflamatoria que ocurre debido a una agresión endodóntica a largo plazo. Es más frecuente en el varón caucásico, durante la tercera década de la vida, en la porción anterior del maxilar. Son comúnmente hallazgos radiográficos, debido a su aspecto asintomático. En este estudio informamos acerca de un quiste periapical, en la porción correspondiente a los dientes 21, 22 y 23, que se trató mediante enucleación, apicectomía y relleno de raíz retrógrada con agregado de trióxido mineral (MTA) de los dientes 21 y 22, relleno de la cavidad del quiste con injerto óseo xenogénico Gen-Ox y una membrana de colágeno GenDerm. Las observaciones después de tres meses mostraron una buena y rápida regeneración ósea, con conservación de la salud periodontal y periapical de los dientes involucrados.

Humans , Male , Middle Aged , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Maxillary Diseases/pathology , Maxillary Diseases/diagnostic imaging , Odontogenic Cysts/pathology , Odontogenic Cysts/diagnostic imaging , Bone Transplantation/methods , Radicular Cyst/diagnostic imaging , Bone Substitutes/therapeutic use , Oral Surgical Procedures
Autops. Case Rep ; 9(2): e2018073, Abr.-Jun. 2019. ilus
Article in English | LILACS | ID: biblio-999529


A mandibular buccal bifurcation cyst is an inflammatory cyst that usually occurs on the buccal aspect of the permanent mandibular first molar of children. This lesion is diagnosed by an association of radiographic, clinical, and histological features. We report a bilateral case of mandibular buccal bifurcation cyst and discuss the main findings of this entity. A 7-year-old girl presented pain and delayed dental eruption in the posterior mandibular region. A cone beam computed tomography was performed and revealed hypodense lesions involving the crown and root of the mandibular first molars, with expansion of the buccal cortical and lingual tilting of the molar roots. A biopsy was carried out, and the common features of an inflammatory odontogenic cyst were histologically observed. The final diagnosis was bilateral mandibular buccal bifurcation cyst. Clinicians need to be aware of this diagnostic possibility in cases of mandibular cysts in children­especially when bilateral­to perform the correct treatment, which should not involve the extraction of the affected tooth.

Humans , Female , Child , Mandibular Diseases/pathology , Odontogenic Cysts/diagnostic imaging , Jaw Cysts , Odontogenic Cysts/pathology
Int. j. odontostomatol. (Print) ; 13(1): 5-10, mar. 2019. graf
Article in Spanish | LILACS | ID: biblio-990057


RESUMEN: La hiperplasia condilar (HC) es un término genérico de una condición patológica que se utiliza para describir situaciones que causan el crecimiento excesivo y sobredesarrollo del cóndilo mandibular, repercutiendo así también en la mandíbula, es la responsable de alrededor del 50 % de las asimetrías faciales y se presenta con mayor frecuencia entre los 11 y 30 años de edad. Se presenta un caso clínico de una paciente femenina de 21 años de edad que presentaba hiperplasia condilar unilateral izquierda con compensación alveolodentaria. Se realizó condilectomía alta con abordaje endoaural para retirar 5 mm de la parte superior del cóndilo y osteotomía mandibular mediante abordaje intraoral circunvestibular, con disección y preservación del nervio dentario inferior, retirando 8 mm del aspecto inferior de la mandíbula de acuerdo a los requerimientos estéticos. El brindar un tratamiento adecuado a la hiperplasia condilar enfocado a corregir las secuelas tanto funcionales como estéticas es de gran beneficio al paciente ya que le permite mejorar su calidad de vida, el correcto diagnóstico es vital para poder planear un tratamiento exitoso.

ABSTRACT: Condylar hyperplasia (CH) is a generic term for a pathological situation that is used to describe conditions that cause excessive growth and overdevelopment of the mandibular condyle and also impacting on the jaw, this bone formation is responsible about of 50 % of all deformities facial and it occurs most frequently between 11-30 years old. This case report is about a 21-years old female who showed unilateral condylar hyperplasia of left side with alveolodentary compensatory. Was carried out high condilectomy through an endoaural approach removing 5 mm of the upper condyle and the mandibular osteotomy was performed through intraoral approach with dissection and preservation of the inferior alveolar nerve, removing 8 mm of the inferior aspect of the mandible according to the aesthetic requirements. An appropriate treatment for the condylar hyperplasia focused on correcting the side effects such as functional or aesthetic it's of great benefit for the patient because it allows improve their quality of life. A correct diagnosis is very important to planning a successful treatment.

Humans , Female , Young Adult , Mandibular Diseases/surgery , Mandibular Condyle/surgery , Radiography, Panoramic , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Esthetics, Dental , Facial Asymmetry/surgery , Orthognathic Surgical Procedures/methods , Hyperplasia , Mandibular Condyle/pathology , Mandibular Condyle/diagnostic imaging
J. oral res. (Impresa) ; 7(9): 437-441, ene. 2, 2018. ilus
Article in English | LILACS | ID: biblio-1121165


The formation of a new joint between a pathologically enlarged coronoid process and the body of the malar bone is known as Jacob's disease. hyperplasia of the coronoid process was first described in 1853 by von Langenbeck, and it was not until 1899 when Oscar Jacob described the disease that was named after him. Jacob's disease is an uncommon entity with only a few cases documented in the literature. the condition manifests at first with progressive limitation of the oral opening and facial asymmetry. the pain is infrequent and mainly affects young patients. temporal muscle hyperactivity, cranial trauma, chronic displacement of the ipsilateral temporomandibular joint, endocrine stimuli and genetic alterations have been postulated as possible factors. the definitive diagnosis is by histopathology and it is necessary that bone hyperplasia is confirmed, as well as the presence of cartilage and synovial capsule forming the new joint between the malar bone and the coronoid process. we present a 10-year-old patient with a history of childhood trauma in the left preauricular region. it presented to our service with a history of progressive limitation of the oral opening. computed tomography (CT) revealed an elongation of the bilateral coronoid process, in contact with homolateral zygomatic bone, causing its deformation. surgery under general anesthesia was performed through the intraoral vestibular route. histopathology confirmed the diagnosis of Jacob's disease. we review the literature regarding the etiology, pathogenesis, clinical characteristics, diagnosis and treatment of this condition.

Humans , Male , Child , Mandibular Diseases/surgery , Mandibular Diseases/pathology , Mandibular Osteotomy/methods , Hyperplasia/surgery , Mandibular Diseases/diagnosis , Tomography, X-Ray Computed , Treatment Outcome
J. appl. oral sci ; 26: e20170535, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-954504


Abstract Giant Osteosclerotic Lesions (GOLs) are a group of rarely reported intraosseous lesions. Their precise diagnosis is important since they can be confused with malignant neoplasms. Objective This retrospective study aimed to record and analyze the clinical and radiographic Giant Osteosclerotic Lesions (GOLs) detected in the maxillomandibular area of patients attending to our institution. Materials and Methods: Informed consent from the patients was obtained and those cases of 2.5 cm or larger lesions with radiopaque or mixed (radiolucid-radiopaque) appearance located in the maxillofacial bones were selected. Assessed parameters were: age, gender, radiographic aspect, shape, borders, size, location and relations to roots. Lesions were classified as radicular, apical, interradicular, interradicular-apical, radicular-apical or located in a previous teeth extraction area. Additionally, several osseous and dental developmental alterations (DDAs) were assessed. Results Seventeen radiopacities in 14 patients were found and were located almost exclusively in mandible and were two types: idiopathic osteosclerosis and condensing osteitis. GOLs were more frequent in females, and in the anterior and premolar zones. 94.2% of GOLs were qualified as idiopathic osteosclerosis and one case was condensing osteitis. All studied cases showed different osseous and dental developmental alterations (DDAs). The most common were: Microdontia, hypodontia, pulp stones, macrodontia and variations in the mental foramina. Conclusions GOLs must be differentiated from other radiopaque benign and malignant tumors. Condensing osteitis, was considered an anomalous osseous response induced by a chronic low-grade inflammatory stimulus. For development of idiopathic osteosclerosis, two possible mechanisms could be related. The first is modification of the normal turnover with excessive osseous deposition. The second mechanism will prevent the normal bone resorption, arresting the osseous breakdown process.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Osteosclerosis/diagnostic imaging , Mandibular Diseases/diagnostic imaging , Maxillary Diseases/diagnostic imaging , Osteitis/pathology , Osteitis/diagnostic imaging , Osteosclerosis/pathology , Radiography, Panoramic , Mandibular Diseases/pathology , Maxillary Diseases/pathology , Retrospective Studies , Diagnosis, Differential , Middle Aged
J. appl. oral sci ; 26: e20170288, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893711


Abstract Idiopathic Bone Cavity (IBC) or Simple Bone Cyst (SBC) is a non- epithelialized bone cavity with serosanguinous fluid content or empty. There is a literature debate regarding its pathogenesis that remains unclear. The main treatment option is the surgical exploration, although there are successful cases described in the literature in which just a follow-up with clinical and radiographic evaluation was performed. Objective This study aimed to assess the spontaneous resolution of idiopathic bone cavity untreated by surgery. Material and Methods Twenty-one patients diagnosed with surgically untreated IBC were submitted to a follow-up protocol modified from Damante, Guerra, and Ferreira5 (2002). A clinical and radiographic evaluation was performed in 13 patients (13/21), while eight patients (8/21) were only radiographically evaluated. Three observers evaluated the panoramic radiographs of 21 patients and the Kappa test was performed by intra and inter-examiners. Inductive and descriptive statistics were applied to the results. Results Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. Most of the cysts evaluated were rated as 3 (lesion "in involution"), 4 (lesion "almost completely resolved"), or 5 ("completely resolved"). Conclusions We observed progressive spontaneous resolution of IBC. Most cysts were found in the recovery process in different follow-up periods. Patient's follow-up, without surgery, may be considered after the diagnosis based on epidemiological, clinical, and radiographic features of the lesion.

Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Remission, Spontaneous , Bone Cysts/pathology , Mandibular Diseases/pathology , Time Factors , Bone Cysts/physiopathology , Bone Cysts/diagnostic imaging , Radiography, Panoramic , Mandibular Diseases/physiopathology , Mandibular Diseases/diagnostic imaging , Sex Factors , Age Factors , Cone-Beam Computed Tomography
Braz. oral res. (Online) ; 32: e20, 2018. tab
Article in English | LILACS | ID: biblio-889492


Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Humans , Male , Female , Infant , Child , Mandibular Diseases/epidemiology , Mouth Diseases/epidemiology , Age Distribution , Biopsy , Brazil/epidemiology , Mandibular Diseases/pathology , Mouth Diseases/pathology , Mouth Mucosa/pathology , Mucocele/epidemiology , Mucocele/pathology , Prevalence , Retrospective Studies , Sex Distribution
Braz. oral res. (Online) ; 31: e25, 2017. tab, graf
Article in English | LILACS | ID: biblio-839516


Abstract This study aimed at verifying the correlation among angulation of the articular eminence (AE), shape of the condyle and its degenerative bone diseases (DBDs), according to age and sex, through Cone Beam Computed Tomography (CBCT). Five hundred and twenty-eight temporomandibular joints (TMJ) were evaluated. The condyles were classified as: flat, convex, angled and rounded, and the AE angulation was measured. The DBDs evaluated were osteophytes, flattening, erosion, subcortical cysts and spinal sclerosis. There was no difference in the mean angulations in relation to age group (p>0.05). In age groups of 60-69 years (p=0.003) and 70 years or over (p=0.021), the angulation was higher in males. There was an association between DBD and sex (p=0.047), in that the prevalence was higher in females. Differences in AE angles were not observed in condyles with one or no DBDs (p>0.05). However, the presence of two or more DBDs led to a decrease in the angle (p<0.05). Angled condyles showed higher AE angulations than the flat and convex types (p<0.01). In conclusion, the AE inclination is influenced by DBD and condyle shape; an association of two or more bone diseases in the condyle, or its flat or convex anatomy, results in a decrease in the angulation.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Mandibular Condyle/diagnostic imaging , Mandibular Condyle/pathology , Temporomandibular Joint/diagnostic imaging , Temporomandibular Joint/pathology , Age Factors , Analysis of Variance , Cone-Beam Computed Tomography , Cross-Sectional Studies , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/pathology , Reference Values , Retrospective Studies , Sex Factors , Statistics, Nonparametric
Odonto (Säo Bernardo do Campo) ; 20(40): 67-72, jul.-dez. 2012. tab, graf
Article in Portuguese | LILACS, BBO | ID: lil-790181


Introdução: O Tumor Odontogênico Ceratocístico (TOC) pode ser definido como um tumor intraósseo, benigno, de origem odontogênica. A incidência dessa lesão na mandibula é de 3 a 4 vezes maior que na maxila, com preferência pela região dos terceiros molares inferiores, no ângulo da madíbula, de onde se estende para o ramo ascentende. Em casos de lesões mais extensas, observa-se tumefação, drenagem ou dor associada, aumento de volume de tecidos moles e tecido ósseo, parestesia, mobilidade de dentes envolvidos pela lesão, bem como crescimento lento e deslocamento de peças dentárias. Objetivo e Metodologia: O objetivo deste trabalho foi realizar uma revisão da literatura e um levantamento de casos diagnosticados no Laboratóro de Patologia do Instituto de Ciências Biológicas da UPF a respeito do TOC. Resultados: No presente levantamento, foram encontrados 48 casos de TOC, com uma prevalencia do gênero feminino, na segunda e terceira década de vida. Um maior número de casos ocorreram na mandibula com preferencia pela região de terceiro molar inferior. Apresentavam em sua maioria lesões radiolúcidas uniloculares e o principal sinal clínico foi o de abaulamento. Conclusão: O que pode-se concluir através deste trabalho é que é fundamental para o sucesso do tratamento do Tumor Odontogênico Ceratocístico, o conhecimento por parte do Cirurgião Dentista de lesões tumorais de origem odontogênica , para que um correto e precoce diagnóstico seja executado, levando a melhor escolha do tratamento e, consequentemente um prognóstico favorável.

Introduction: The Keratocystic odontogenic tumor can be defined like an intraosseous tumor, benign, of odontogenic origin. The incidence of this lesion in the mandible and 3 to 4 times higher than in the maxilla, with a preference for the third molar region. In cases of more extensive lesions, there is swelling, drainage or pain associated, swelling of soft tissue and bone tissue, paresthesia, mobility of teeth involved by the injury, as well as slow growth and displacement of dental pieces. Objective and Methodology: The objective of this study was a literature review and a survey of cases diagnosed in the Pathology Lab of the Institute of Biological Sciences, UPF, about keratocystic odontogenic tumor. Result: In this survey, we found 48 cases of TOC, with a prevalence of females in second and third decade of life. A greater number of cases occurred in the jaw with a preference for the third molar region. Had mostly unilocular radiolucent lesions and was the main clinical sign of bulging. Conclusion: What can be concluded from this work is that it is essential for the successful treatment of odontogenic tumor keratocystic, knowledge by the Surgeon Dentist of odontogenic origin tumors, for a correct and early diagnosis is performed, taking the best choice of treatment and thus a favorable prognosis.

Humans , Male , Female , Child , Adolescent , Young Adult , Middle Aged , Odontogenic Cysts/epidemiology , Odontogenic Cysts/pathology , Odontogenic Tumors/epidemiology , Odontogenic Tumors/pathology , Age Distribution , Brazil/epidemiology , Mandibular Diseases/epidemiology , Mandibular Diseases/pathology , Maxillary Diseases/epidemiology , Maxillary Diseases/pathology , Sex Distribution
Braz. dent. j ; 23(5): 612-616, Sept.-Oct. 2012. ilus
Article in English | LILACS | ID: lil-660370


Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facial cellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed.

Os cistos odontogênicos ortoceratinizados (COOs) são cistos de desenvolvimento revestidos por epitélio ortoceratinizado constituído por uma camada granulosa proeminente e uma camada basal de células cuboidais achatadas que não mostram tendência à paliçada. Esses cistos foram considerados uma entidade distinta dos ceratocistos, uma vez que apresentam um comportamento menos agressivo e uma taxa muito baixa de recorrência. Cistos odontogênicos de desenvolvimento pode tornar-se infectados, mas complicações graves como a celulite, potencialmente ameaçadora da vida, são raros. Este relato descreve um caso raro de celulite facial secundária a um COO infectado localizado na mandíbula de um homem de 27 anos de idade. A literatura relevante sobre as características clínicopatológicas do COO foi revisada.

Adult , Humans , Male , Cellulitis/etiology , Mandibular Diseases/pathology , Odontogenic Cysts/complications , Cellulitis/pathology , Keratins/physiology
Int. j. odontostomatol. (Print) ; 6(2): 225-228, ago. 2012. ilus
Article in Spanish | LILACS | ID: lil-657694


La hipertrofia del proceso coronoides mandibular es una patología rara, progresiva y de etiología desconocida, que se caracteriza por el desarrollo exagerado del proceso coronoides determinando aumento en su tamaño, resultando en una progresiva y dolorosa limitación de la apertura bucal. La hipomovilidad mandibular es un síntoma presente en diversas enfermedades y asociarla a una causa específica requiere exámenes clínicos e imagenológicos minuciosos. La tomografía computarizada cone-beam tiene el potencial de ofrecer informaciones complementarias superiores a las radiografías convencionales. Además, elimina superposiciones, ofrece alta resolución de imagen, lo que ayuda no solo el diagnóstico, sino también la planificación del procedimiento quirúrgico. Presentamos un caso de paciente de sexo masculino que acudió a la consulta para evaluación de trismus. No presentaba dolor, solo incomodidad por limitación progresiva de apertura bucal. Mediante el examen físico, solo se observó la limitación de apertura bucal. Aunque los movimientos de lateralidad y protrusión eran posibles, estaban muy limitados. Se realizó examen de tomografía computarizada cone-beam, que evidenció imagen compatible con hipertrofia bilateral del proceso coronoides mandibular.

The hypertrophy of the mandibular coronoid process is a rare condition, progressive and of unknown etiology, characterized by the over development of the coronoid process determining their size increased, resulting in progressive and painful limitation of mouth opening. The mandibular hypomobility is a present symptom in several diseases and associates it to a specific cause requires detailed clinical and imaginologic examination. The cone-beam computed tomography has the potential to provide complementary informations above than conventional radiography. It also has the advantage of eliminate overlaps, provide high resolution image, helping not only in diagnosis, but also in planning the surgical procedure. Here we report a case of male patient, who appeared at the clinic for an evaluation of a trismus. He had no pain, only discomfort for progressive limitation of mouth opening. On physical examination, only a limited mouth opening has been found. Although the movements of laterality and protrusión were posible, they were very limited. Cone-beam computed tomography examination was performed, that showed an image compatible with bilateral hypertrophy of the mandibular coronoid process.

Humans , Male , Adult , Mandibular Diseases/pathology , Mandibular Diseases , Cone-Beam Computed Tomography/methods , Hypertrophy , Trismus/etiology
Braz. oral res ; 26(4): 330-334, July-Aug. 2012. tab
Article in English | LILACS | ID: lil-640719


The purpose of this study was to determine the prevalence of odontogenic cysts and to identify their clinico-pathological features among patients by studying biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 10 years. Data for the study were retrieved from the case records of patients fitting the histological classification of the World Health Organization (1992). Analyzed clinical variables included age, gender, anatomical location, and histological diagnosis. Of the 2275 biopsy reports analyzed, 194 cases (8.5%) were jaw cysts, including odontogenic (6.7%) and nonodontogenic cysts (0.25%). Odontogenic cysts included 69.3% radicular, 20.3% dentigerous, 5.2% keratinizing odontogenic, 3.3% residual, and 1.9% other cysts, such as lateral periodontal, botryoid odontogenic, and gingival cysts. The most frequent clinical manifestation was swelling, followed by a combination of pain and swelling. Age, gender, and location were related to the etiopathologic characteristics of the cyst type. A definitive diagnosis can be made on the basis of clinical, radiological, and histological findings, which makes a good interdepartmental relationship between the clinicians and pathologists essential. Knowledge of the biological and histological behavior of the odontogenic cysts is required for their early detection and treatment.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Middle Aged , Young Adult , Odontogenic Cysts/epidemiology , Odontogenic Cysts/pathology , Age Distribution , Age Factors , Biopsy , India/epidemiology , Mandibular Diseases/epidemiology , Mandibular Diseases/pathology , Maxillary Diseases/epidemiology , Maxillary Diseases/pathology , Prevalence , Sex Distribution
Odonto (Säo Bernardo do Campo) ; 20(39): 27-33, jan.-jun. 2012. ilus
Article in Portuguese | LILACS, BBO | ID: lil-790158


Introdução: os bifosfonatos são um grupo de medicamentos utilizados no tratamento de doenças malignas metastáticas e em outras doenças ósseas como osteoporose e doença de Paget. Seu mecanismo de ação reduz a reabsorção óssea, a inibição do recrutamento e promoção da apoptose de osteoclastos. Apesar dos grandes benefícios para pacientes nestas condições, uma complicação associada ao seu uso é aosteonecrose dos maxilares. Objetivo: relatar um caso clínico envolvendo um paciente do sexo masculino de 72anos, sob tratamento endovenoso mensal com ácido zoledrônico, que evoluiu com osteonecrose espontânea bilateral em região posterior mandibular após um ano sob uso desta medicação. Conclusão: a conscientização dos Cirurgiões Dentistas quanto à etiologia da osteonecrosee a manutenção de ótima higiene oral nos pacientes sob uso destes medicamentos são fundamentais na prevenção da ocorrência desta condição.

Introduction: Biphosphonates are a group of drugs used to treat metástases associated with breast or prostate cancer and other bone diseases, including osteoporosis and Paget disease. They inhibit bone resorption through na action on osteoclasts slowing their activity and inducing apoptosis. Despite the benefits of biphosphonates, osteonecrosis of the jaw (ONJ) has emerged as a serious complication in some patients treated with these drugs. Aim: a case report of a 72-year-old male treated with zoledronic acid for one year that presented spontaneous bilateral ONJ is presented. Conclusion: the awareness of the dentists regarding the etiology of the ONJ and the maintenance of a great oral hygine by the patients under these medications are essencial for preventing this condition.

Humans , Male , Aged , Bisphosphonate-Associated Osteonecrosis of the Jaw , Diphosphonates/adverse effects , Mandibular Diseases/chemically induced , Imidazoles/adverse effects , Bisphosphonate-Associated Osteonecrosis of the Jaw , Mandibular Diseases/pathology , Radiography, Panoramic
Article in English | IMSEAR | ID: sea-141246


In dental practice, impacted third molar teeth are a common finding. The dentists usually remove them if they are associated with some radiographic finding suggestive of a cyst or a tumor or if they cause pain or resorption of the adjacent teeth. It has been found that, in many cases, even the radiographically and clinically asymptomatic impacted mandibular third molars are associated with some pathology. This paper brings into the light two cases with clinically and radiographically normal impacted third molar teeth associated with dentigerous cyst, thus highlighting that the radiographic appearance is not a reliable indicator of the absence or presence of pathology associated with the impacted third molars.

Adult , Biopsy , Collagen , Connective Tissue/pathology , Dentigerous Cyst/pathology , Dentigerous Cyst/diagnostic imaging , Diagnosis, Differential , Epithelium/pathology , Female , Humans , Mandible/diagnostic imaging , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Molar, Third/diagnostic imaging , Radiography, Panoramic , Tooth, Impacted/diagnostic imaging , Young Adult
Odonto (Säo Bernardo do Campo) ; 19(37): 25-32, jan.-jun.2011. ilus
Article in English | LILACS | ID: lil-789947


The keratocystic odontogenic tumor (KOT) is a relatively common oral and maxillofacial lesion that arises from rests of dental lamina. It has an agressive behavior including high rates of recurrence, rapid growth, and extension into adjacent tissues. Various treatment modalities, and thus differing recurrence rates after treatment, have been reported. Due to the very thin and friable lining, characteristic of the tumor, enucleation can be difficult undertaking and, for this reason it is associated with the highest recurrence rates.Aim: we describe a case of a large KOT in the mandibular body, where due to the presence of an unusual thick lining, removal of the tumor as a single piece was sucessful.Conclusion: this case shows that large KOT can be treated in a conservative approach. Due to the possible recurrences many years after initial treatment, a life-long follow-up schedule is mandatory...

O tumor odontogênico ceratocístico (TOC) é uma lesão oral e maxilofacial relativamente comum que surge de restos da lâmina dental. Ele tem um comportamento agressivo, incluindo altas taxas de recorrência, crescimento rápido e extensão para os tecidos adjacentes. Várias modalidades de tratamento e, assim, diferentes taxas de recorrência após o tratamento, foram relatadas. Devido ao revestimento muito fino e friável, característica do tumor, a enucleação pode ser difícil e, por esta razão ele é associado com as maiores taxas de recorrência. Objetivo: o presente trabalho descreve um caso de um grande TOC no corpo mandibular, onde, devido à presença de um revestimento de espessura incomum, a remoção do tumor como uma peça única foi bem sucedida. Conclusão: o presente caso demonstra que TOC de grandes proporções podem ser tratados de maneira conservadora. Devido à possibilidade de recidiva em muitos anos após o tratamento inicial, acompanhamento a longo prazo é obrigatório...

Humans , Male , Middle Aged , Odontogenic Cysts/surgery , Odontogenic Cysts/pathology , Mandibular Diseases/surgery , Mandibular Diseases/pathology , Odontogenic Cysts , Mandibular Diseases , Radiography, Panoramic , Treatment Outcome
Odonto (Säo Bernardo do Campo) ; 19(37): 99-105, jan.-jun.2011. ilus
Article in Portuguese | LILACS | ID: lil-789956


O cisto ósseo traumático é considerado um pseudocisto que ocorre com baixa freqüência, representando aproximadamente 1% dos cistos dos maxilares. É uma cavidade dentro do osso delimitada por tecido conjuntivo, podendo estar vazia ou contendo fluido. Geralmente é descoberto num exame radiográfico de rotina e a maior incidência ocorre no corpo da mandíbula, radiograficamente caracteriza-se como uma área radiolúcida unilocular bem definida, com um limite oval ou festonado. A lesão costuma contornar as raízes dos dentes adjacentes.Relato de caso: o presente trabalho tem como objetivo relatar um caso clínico de cisto ósseo traumático em região incomum de processo condilar em paciente jovem, descrevendo as características clínicas, histopatológicas, radiográficas, tomográficas, plano de tratamento, prognóstico e acompanhamento do paciente.Conclusão: esta é uma lesão essencialmente benigna do ponto de vista clínico. O diagnóstico deverá ser feito com exames clínicos, radiográficos/tomográfico e histopatológico. O tratamento, na maioria das vezes, envolverá exploração cirúrgica com curetagem, tendo um excelente prognóstico...

The traumatic bone cyst is considered a pseudocist not frequently observed, representing approximately 1% of the maxilares cysts. It is a cavity inside the bone tissue, which may be empty or containing fluid. Usually it is found in routine radiographic examination and more frequently in the mandible body. It is usually located on the symphysis or body of mandible region as a well defined an only radilucent area.Case report: the aim of this work is to present a report case of an traumatic bone cyst, in unusual area of mandibular ramus observed in a young patient. It describes the clinical, hispathological, radiographic and tomographic characteristics of the case, a treatment plan, a prognostic and patient observation informations. Conclusion: this is an essentially benign lesion from a clinical standpoint. The diagnosis should be done with clinical, radiographic/tomographic and histopathologic. In most cases the treatment will involve exploratory surgery with curettage, with an excellent prognosis...

Humans , Male , Child , Jaw Cysts , Mandibular Condyle/pathology , Mandibular Condyle , Mandibular Diseases/pathology , Mandibular Diseases , Radiography, Dental, Digital , Radiography, Panoramic , Tomography, X-Ray Computed
Article in English | IMSEAR | ID: sea-139975


The solitary or traumatic bone cyst (TBC) is an uncommon non-epithelial lined cavity of the jaws. The lesion is mainly diagnosed in young patients most frequently during the second decade of life. The majority of them are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic and is often accidentally discovered on routine radiological examination. The definite diagnosis of traumatic cyst can only be determined at surgery. Often, the material for histological examination may be scanty or non-existent. We present a documented case of a solitary bone cyst involving the body of the mandible. A brief review of literature regarding the main characteristics of the lesion is provided.

Adult , Humans , Incidental Findings , Jaw Cysts/pathology , Jaw Cysts/diagnostic imaging , Jaw Cysts/surgery , Male , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/surgery , Treatment Outcome
Article in English | IMSEAR | ID: sea-139973


The objective of the article is to highlight and make people aware of a rare abscess which is often missed or misdiagnosed. As only a few cases have been reported, the authors feel that reporting such a case would help in proper management of the disease. We are presenting a 6.5-year-old male child with 3 weeks history of right facial swelling in the parotid region, with low-grade fever and trismus. Submasseteric abscess is a rare abscess which is often misdiagnosed as a parotid abscess or parotitis. Only a few cases have been reported. The cause is mostly dental in origin. Intravenous antibiotics often fail to alleviate the symptoms as this is a closed space and needs prompt drainage. Therefore, awareness of this complication of dental infections is vital for proper diagnosis and timely management.

Abscess/complications , Abscess/diagnostic imaging , Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Child , Combined Modality Therapy , Diagnosis, Differential , Drainage , Humans , Male , Mandibular Diseases/etiology , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/therapy , Masseter Muscle , Parotid Diseases/diagnosis , Toothache/complications , Toothache/diagnostic imaging , Toothache/therapy , Treatment Outcome