Treatment of lingual nerve paresthesia through photobiomodulation therapy: a case report employing an approach integrating extraoral and intraoral modalities

Aims: Oral nerve injuries are the primary cause of paresthesia in the head and neck regions. To report the managing of a combined protocol involving extraoral and intraoral photobiomodulation (PBM) therapy for lingual nerve paresthesia. Case report: A 38-year-old female patient underwent 25 PBM sessions using laser with dual wavelength infrared (810nm + 980 nm). The extraoral application included 6 seconds and 6J per point. per point, 1W, 4.91 cm², 1.2 J/cm. The intraoral protocol with 0.3W of power, a spot size of 0.38 cm², 15.78 J/cm² of energy density, 6J of energy per point, for 20 seconds. Results: Assessment of neurosensitivity on the dorsum of the tongue was a 75% improvement. On the lateral tongue improved to 50%. In the floor of the mouth, PBM demonstrated a 25% improvement. Conclusion: PBM is an important treatment option in the case of lingual nerve paresthesia. The use of PBM should be considered as a feasible, non-invasive treatment approach.

Cistos e tumores odontogênicos: estudo retrospectivo dos casos diagnosticados no período de 10 anos em um hospital no sul do Brasil / Odontogenic cysts and tumors: a retrospective study of the cases diagnosed in a period of 10 years in a southern Brazilian hospital

Introdução: as lesões odontogênicas (LOs) compreendem um grupo heterogêneo de patologias orais e maxilofaciais que apresentam características distintas. O objetivo do presente estudo foi identificar as características clínico--patológicas das LOs diagnosticadas em um hospital da região sul do Brasil. Materiais e métodos: foi realizado um estudo retrospectivo para levantamento dos casos com diagnóstico histopatológico de LOs no período entre 2007 e 2017. Os laudos dos pacientes foram avaliados para extração das características clínico-patológicas e dos diagnósticos histopatológicos de cada caso. Resultados: um total de 255 casos de LOs foram identificados. Destes casos, 197 (77%) cistos odontogênicos e 58 (23%) tumores odontogênicos foram coletados, sendo que somente um caso (0,39%) possuiu o diagnóstico de neoplasia odonto-gênica maligna. Os diagnósticos mais prevalentes foram cisto radicular (32,5%) e cisto dentígero (31,76%), seguidos de ceratocisto odontogênico (10,98%), odontoma (10%) e ameloblastoma (10%). A maioria dos casos acometeu mandíbula (53,7%), com uma discreta predileção pelo sexo feminino (51%). A média de idade foi de 34±20,53 anos. Discussão: os dados apresentados corroboram com a literatura no que se refere à raridade do diagnóstico de tumores odontogênicos. Conclusão: o presente estudo demonstrou as principais características clínico-pato-lógicas de LOs diagnosticadas em um hospital no sul do Brasil, contribuindo para um maior conhecimento do perfil destas lesões.

Introduction: odontogenic lesions (OLs) represent a heterogeneous group of oral and maxillofacial patho-logies presenting distinct characteristics. The present study aimed to identify the clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital. Materials and methods: a retrospective study was performed to evaluate cases with histopathological diagnosis of OLs identified in the period between 2007 and 2017. The patient's medical records were evaluated in order to obtain the clinical and pathological charac-teristics and the histopathological diagnosis from each case. Results: a total of 255 cases of OLs were identified. From these, 197 (77%) odontogenic cysts and 58 (23%) odontogenic tumors were surveyed, with only one case (0,39%) of a malignant odontogenic neoplasm. The most prevalent diagnosis were radicular cyst (32.5%) and den-tigerous cyst (31.76%), followed by odontogenic keratocyst (10.98%), odontoma (10%) and ameloblastoma (10%). The majority of the cases affected the mandible (53.7%) with a slight preference by female individuals (51%). The mean age was 34±20.53 years old. Discussion: the presented data are in accordance with the literature regarding the rarity of the diagnosis of odontogenic tumors.Conclusion: the present study demonstrated the main clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital, contrib-uting to a better understanding of these injuries profiles.

Oral and oropharyngeal diffuse large B-cell lymphoma and high-grade B-cell lymphoma: A clinicopathologic and prognostic study of 69 cases.

OBJECTIVE: The objective of this study was to describe the clinicopathological, molecular, and prognostic features of oral/oropharyngeal diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma. STUDY DESIGN: All cases were retrieved from 7 Brazilian institutions. Immunohistochemical reactions were performed to confirm the diagnoses and to categorize the tumors. In situ hybridization was used to detect Epstein-Barr virus (EBV) and fluorescence in situ hybridization was used to identify gene rearrangements. RESULTS: Most cases involved the oral cavity (76.8%). Males and females, with a mean age of 60 years, were evenly affected. Tumors mostly presented as painful swellings. Forty cases represented germinal center B-cell type (58%). Five cases presented double-hit translocation and 3 harbored rearrangement for MYC/BCL2/BCL6. EBV was detected in 3 cases (4.3%). The 5-year overall survival was 44.4%. Female sex, presence of pain and ulcer, microscopic "starry sky pattern" and necrosis, co-expression of c-Myc/Bcl2, and translocation of MYC were associated with a lower survival in univariate analysis (P = .05, P = .01, P = .01, P = .03, P = .05, P = .006, P = .05, respectively). CONCLUSION: Patients affected by oral/oropharyngeal DLBCL have a low survival rate. High-grade B-cell lymphoma (17.7%) and EBV-positive DLBCL, not otherwise specified (4.3%) account for a small number of cases.

Oral mucositis in childhood cancer patients receiving high-dose methotrexate: Prevalence, relationship with other toxicities and methotrexate elimination.

BACKGROUND: Oral mucositis (OM) is one of the main adverse effects of the chemotherapeutic agent methotrexate (MTX). AIM: To evaluate the relationship of OM with MTX metabolism time and other toxicities in childhood, cancer patients receiving high-dose of methotrexate (HD-MTX). DESIGN: Seventy-seven childhood patients receiving HD-MTX for treatment of leukaemia, osteosarcoma or lymphoma were evaluated. MTX serum level, hepatic and renal function parameters, and presence and intensity of OM were analysed. RESULTS: The patients were submitted to 255 cycles of chemotherapy. OM was diagnosed in 191 (74.9%) cycles. Of these, 119 (46.6%) presented ulcerative lesions. Lymphoma was associated with severe OM (P = .01). OM was associated with higher serum levels of aspartate aminotransferase (P = .006), alanine aminotransferase (P = .04) and creatinine (P = .008). Increase of one unit of total bilirubin and indirect bilirubin associated, respectively, with 11% and 39% higher prevalence of OM. For each increase of one unit of creatinine serum level, it was observed a 37% higher prevalence of OM in patients with lymphoma. No association was found between delayed excretion of MTX and OM development. CONCLUSIONS: OM is a prevalent complication of childhood cancer patients receiving HD-MTX. Renal and hepatic toxicity could be considered risk factors for OM, especially in patients with lymphoma.