ABSTRACT
OBJECTIVES:: Brazilians who are free of traditional atherogenic risk factors frequently suffer myocardial infarctions (MI). Calcified carotid artery plaque (CCAP) on panoramic images (PIs) has been shown to be a validated "risk indicator" of future MIs. The diagonal earlobe crease (DELC) is likewise a validated "risk indicator" of future MI. We sought to determine the prevalence of DELC+ among patients having CCAP+ on their PIs. METHODS:: In a masked cross-sectional study, three dentists evaluated PIs of patients (N = 481) over age 55 for presence of CCAP+. Among the CCAP+ cohort, the presence of DELC+ was determined by two additional dentists masked to the presence of CCAP+ on PIs. A control group (CCAP-) comprised of individuals with PIs devoid of plaque was similarly evaluated for evidence of DELC+. RESULTS:: A mixed-gender group (8.6%) of patients (N = 41; mean age 67.5 ± 6.8) evidenced CCAP+ on their PIs and approximately 88% of these individuals (N = 36) had concomitant DELC+. Among members of the control group (N = 41), 17 patients were DELC+. Our results demonstrated that among the full mixed-gender cohort (N = 82), the association between CCAP+ and DELC+ was statistically significant (p = 0.0001). However, when adjusting for gender, only the CCAP+ men were significantly (p = 0.00011) more likely to evidence DELC+ on clinical examination. CONCLUSIONS:: Males with atherosclerosis of their carotid arteries as evidenced by PIs displaying calcified atheromas are significantly more likely to evidence a DELC+ than those without an imaged atheroma.
Subject(s)
Carotid Artery Diseases , Carotid Stenosis , Plaque, Atherosclerotic , Radiography, Panoramic , Aged , Carotid Artery Diseases/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Cross-Sectional Studies , Humans , Male , Middle Aged , Plaque, Atherosclerotic/diagnostic imaging , Prevalence , Risk FactorsABSTRACT
OBJECTIVE: To report a case of a challenging oral diagnosis involving a primary diffuse large B cell lymphoma of the oral cavity mimicking a hyperplastic reactive lesion. CASE REPORT: A 72-year-old male patient was referred to the Department of Stomatology presenting a proliferative nodular lesion in the anterior region of the mandible involving the anterior teeth. The clinical examination revealed anterior teeth affected by periodontal disease, suggesting the nodular cession hyperplastic reaction. Incisional biopsy was performed under local anesthesia. The histopathological examination revealed a diffuse proliferation of atypical large lymphoid cells. The tumor cells showed immunopositivity for CD20 and Ki67 (100%) and negativity for CD3, CD30, and CD15. The diagnosis of diffuse large B cell lymphoma was established. The patient underwent chemotherapy and progressed to death after nine months. CONCLUSION: Lymphomas of the oral cavity are rare and may have nonspecific clinical features, mimicking inflammatory and reactive lesions. Therefore, a detailed clinical evaluation associated with histopathological and immunohistochemical analysis should be performed to enable early and accurate diagnoses in suspected oral lesions.
ABSTRACT
Introdução: a exodontia é um procedimento de rotina da cirurgia bucal. Entre as complicações pós-operatórias inerentes a esse procedimento cita-se a alveolite. A etiologia desse processo não está absolutamente clara e geralmente desenvolve dor de intensidade severa entre o primeiro e quarto dias após o procedimento cirúrgico. As condições locais são caracterizadas por perda prematura ou necrose do coágulo sanguíneo e odor desagradável. A literatura relata a utilização de inúmeros medicamentos e técnicas empregadas para o seu tratamento. Objetivo: o objetivo do presente estudo foi obter maiores informações a respeito do tratamento empregado para a alveolite pelos cirurgiões dentistas da área central de Passo Fundo - RS, Brasil. Métodos: foram enviados 102 questionários e 54 foram respondidos, os quais foram analisados descritivamente. Resultados: quarenta e sete cirurgiões-dentistas afirmaram tratar alveolite, sendo a forma mais utilizada de tratamento (46,8%) a curetagem, com irrigação com soro fisiológico. Quanto à utilização de medicação local, 41 (87,2%) utilizam, sendo que o mais prevalente foi o Alveosan® (Odonto Comercial Importadora Ltda., São Paulo - SP, Brasil) (29,2%). Trinta e três profissionais (70,2 %) utilizam algum tipo de medicação sistêmica (analgésico, anti-inflamatório e antibiótico, isolados ou associados). Conclusão: Embora sabido que há di-vergências de opiniões e diversas formas de tratamento para a alveolite na literatura, todas as formas de terapêutica utilizadas pelos cirurgiões dentistas pesquisados estão dentro das relatadas na literatura, porém nemtodas são aceitáveis atualmente.
