Impact of radiotherapy on mandibular bone: A retrospective study of digital panoramic radiographs

PURPOSE: The purpose of this study was to investigate the impact of radiotherapy on mandibular bone tissue in head and neck cancer patients through an analysis of pixel intensity and fractal dimension values on digital panoramic radiographs.MATERIALS AND METHODS: Thirty patients with radiographic records from before and after 3-dimensional (3D) conformational radiotherapy were selected. A single examiner carried out digital analyses of pixel intensity values and fractal dimensions, with the areas of interest unilaterally located in the right angle medullary region of the mandible below the mandibular canal and posterior to the molar region.RESULTS: Statistically significant decreases were observed in the mean pixel intensity (P=0.0368) and fractal dimension (P=0.0495) values after radiotherapy.CONCLUSION: The results suggest that 3D conformational radiotherapy for head and neck cancer negatively affected the trabecular microarchitecture and mandibular bone mass.

Lesões orais da agranulocitose pelo uso de metimazol em pacientes com doença de Graves / Oral lesions of methimazole-induced agranulocytosis in a patient with graves desease

A agranulocitose é uma reação adversa rara atribuída ao uso de medicamentos, caracterizada pela redução acentuada de número de leucócitos. Apresenta manifestações sistêmicas gerais sendo que as lesões iniciais podem ocorrer em cavidade oral e orofaringe. Este artigo relata o caso de uma paciente que desenvolveu um quadro de agranulocitose com lesões bucais devido ao uso de Metimazol, droga geralmente prescrita no tratamento do hiperparatireoidismo, o objetivo deste relato é alertar o cirurgião-dentista para a identificação precoce das lesões da agranulocitose, bem como reforçar a importância da anamnese na rotina diária.

The agranulocytosis is a rare adverse reation attributed to the use of some therapeutic drugs, characterized by a decrease of leukocytes counts. It presents systemic manifestations and the first lesions may accur on the oral and oropharynx region. This case report of patient who developed an agranulocytosis with oral lesions induced by the use of Methimazole, a drug usually prescribed to hypertiroidism treatement. The objective of thus report is to alert the dentist to make a prompt identification of the agranulocytosis lesions and to emphasize the importance of anamnesis on the daily routine.