High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™.

AIM: To describe a clinical case of ultrasound (US) used to evaluate, before, post-immediately, and after 4 months, the facial application of a volumizing and biostimulating substance. BACKGROUND: Detecting the behavior of injected filler materials with high-frequency US-guided application is the future of natural facial rejuvenation with more predictable and satisfactory results. TECHNIQUE: A patient indicated for orofacial harmonization (OFH) procedures through volumizing and biostimulating material application was invited to participate. The technique was performed by applying HArmonyCa™ (Allergan Aesthetics, Irvine, CA, USA) in the gonial, preauricular, and bilateral lateral zygomatic angle regions. The first evaluations used the US images before and after product application with a Logiq e® high-frequency US device (GE Healthcare, Chicago, IL, USA) with a probe/linear transducer of 18 MHz. About 4 months after the procedure, a new assessment with the same initial acquisition pattern was performed. The first evaluation showed normal-looking anatomical structures without the esthetic material. Immediately after the procedure and 4 months later, the assessments presented semi-permanent esthetic fillers as dispersed lobulated hyperechogenic areas with a cloud aspect. CONCLUSION: High-frequency US was efficient in the static evaluation of HArmonyCa™ behavior on the facial skin. CLINICAL SIGNIFICANCE: The US-guided application of injectable products in specific areas has minimal side effects and contributes to more predictable and satisfactory results. How to cite this article: Gouveia RSA, Tostes LLL, Bezerra FV, et al. High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™. J Contemp Dent Pract 2024;25(1):10-14.

Choosing Juvéderm Volux™ to chin augmentation: Case report and flowchart for clinical evaluation.

INTRODUCTION: The development of filler biomaterials with high hyaluronic acid concentrations, cohesiveness, and elastic modulus has become an option for chin augmentation, as the balance of these rheological properties promotes high lifting capacity, providing minimally invasive perceptible improvements in patient appearance. PRESENTATION OF CASE: The present study reviewed clinical and anatomical aspects of patients referred for chin augmentation and created a flowchart to assertively diagnose patients with an indication of Juvéderm® Volux™ for defining the lower third of the face. DISCUSSION: The chin is vital for facial proportions and attractiveness perception. Its relevance to facial appearance is noticed the most when chin size is less than ideal, making other facial areas seem larger or smaller. The adjacent soft tissues of the neck and jaw appear prematurely aged when chin projection or width is inadequate. Hyaluronic acid-based fillers have a confirmed history of safe and effective use for treating facial volume loss or deficiency. CONCLUSION: Juvéderm® Volux™ is a safe, effective, and long-lasting alternative for restoring and creating facial volume and sculpting, shaping, and contouring the chin and jaw.

Mandibular metastasis of primary extrahepatic biliary carcinoma: Case report.

INTRODUCTION AND IMPORTANCE: Cholangiocarcinoma is a malignant neoplasm with a difficult diagnosis and unfavorable prognosis that can appear anywhere in the biliary tree. Anatomically, it can be classified as intra- or extrahepatic, the latter being the most common primary malignancy of the biliary tract. Although bone tissue is the third most common target for metastases in general, metastatic lesions from cholangiocarcinomas are uncommon in the head and neck. CASE PRESENTATION: A 33-year-old female patient undergoing cancer treatment for cholangiocarcinoma was referred to the Oral and Maxillofacial Surgery and Traumatology Service (CTBMF) of the São Vicente de Paulo Hospital in Passo Fundo, Rio Grande do Sul, Brazil, for interdisciplinary follow-up. She presented trismus, dysphagia, pain, necrosis and drainage in the mental region, and an increased volume on the right side of the mandibular body in the region of teeth 47 and 48. An incisional biopsy was performed in this bulging region. The histopathological diagnosis was poorly differentiated carcinoma. The patient was followed-up weekly by the CTBMF team, receiving analgesia and palliative treatment for the extra- and intraoral lesions, controlling opportunistic infections, and improving food intake. DISCUSSION: Metastatic cholangiocarcinomas in the mandible are rare, hence their diagnosis is often late, which may disfavor the prognosis of these conditions. CONCLUSION: Carefully examining patients with mandibular bone lesions is strongly suggested, especially patients with known or previous concomitant malignancy.

Low-level Laser Therapy in the Management of Oral Mucositis Induced by Radiotherapy: A Randomized Double-blind Clinical Trial.

AIM: The present study evaluated the effect of LLLT at red and infrared wavelengths associated with therapeutic measures from the Mucositis Study Group of the Multinational Association of Supportive Care of Cancer and International Society of Oral Oncology (MASCC/ISOO) for preventing and treating RT-induced oral mucositis (OM). MATERIALS AND METHODS: For the study, 80 subjects diagnosed with head and neck cancer (HNC) undergoing treatment were randomized into three groups to apply different photobiomodulation protocols for 42 days, as follows: Group I-LLLT of 660 nm; Group II-LLLT of 810 nm; and Group III-association of wavelengths of 660 and 810 nm. The treatments were performed by properly trained professionals and with equipment calibrated for the intervention. RESULTS: Different OM scores were noted for the groups studied, and the third group had lower scores than Groups I and II (p = 0.012). No difference was noted in the pain score analyzing the groups (p = 0.49). CONCLUSION: The LLLT was effective for OM lesions in individuals treated with radiotherapy associated or not with chemotherapy. When combined, the red and infrared lasers reduce OM scores. CLINICAL SIGNIFICANCE: OM is one of the main adverse effects of antineoplastic therapy in head and neck cancer patients. The evidence supporting the validity of LLLT for OM can improve patients' quality of life.

The epidemiology of proximal femur fractures during COVID-19 emergency in Italy: a multicentric study.

BACKGROUND AND AIM: After the first Italian case of Covid-19, the Government imposed the complete closure of all areas involved by the spread of the virus to contain transmissions. There was a massive reorganization of Hospitals, a stop of all elective activities and a convertion of many hospitals in "Covid Centers''. AITOG (Associazione Italiana Traumatologia e Ortopedia Geriatrica) conducted a retrospective study on all proximal femur fractures surgeries that occurred in this period, to find out whether the pandemic and the correlated lockdown somehow changed the incidence of these events.  Methods: 10 Italian orthopedic centers were involved in the study. Considering the geographic location, three groups were created (North, Centre and South). The considered period is the Italian "Phase 1" (February 23rd - May 3rd 2020). RESULTS: the cohort is composed of 412 patients, 116 male and 296 female (mean age 81.1 ± 9.1 years). The same period of 2019 has been used as control group, with 558 patients, 156 male and 402 female (mean age 84.2 ± 8.0 years). In 2020 we counted 323 (78.4%) fractures occurred at home, 61 (14.8%) in retirement houses and 28 (6.8%) in different locations. We mainly treated fractures with intramedullary nails (n.237 57.5%). Among all patients we had 46 (11.1%) Covid-19 positive. The mortality rate within 30 days was of 51 patients (12.4%); 23 of these died because of complications related to Covid-19 while 31 of  these were in treatment with anticoagulant/antiaggregant. CONCLUSIONS: AITOG analysis demonstrates a decrease in surgical interventions for proximal femur fractures from 2019 to 2020, a reduction in patients mean age and an increase in trauma occurred in domestic environment. We also registered a consistent difference between the North, Center and South of the Country.

Orthognathic surgery and orthodontics associated with orofacial harmonization: Case report.

INTRODUCTION AND IMPORTANCE: Orthognathic surgery aims to restore the functional and esthetic standards of the face and non-surgical or minimally invasive procedures have been optimizing the results of facial orthosurgical treatments. This case report aimed to show the use of minimally invasive techniques that, associated with orthognathic surgery, represent a trend in current oral and maxillofacial rehabilitation. CASE PRESENTATION: A female patient, 28 years old, white, sought care from the Dentistry team of the São Vicente de Paulo Hospital, in Passo Fundo, Brazil, complaining of mandibular prognathism, anteroposterior maxillary deficiency, dental crowding, malocclusion, functional and esthetic changes that negatively affected her psychosocial interactions and stomatognathic function. The treatment involved orthodontics, orthognathic surgery, and orofacial harmonization with dermal fillers. CLINICAL DISCUSSION: The multidisciplinarity among the specialties of Oral and Maxillofacial Surgery and Traumatology, Orthodontics, and Orofacial Harmonization add and contribute to the process of planning and implementing the treatment proposed, as well as the prognosis toward patient satisfaction. CONCLUSION: The surgical procedure associated with minimally invasive facial harmonization not only corrected the functional complaint of the patient but also played an important role in improving facial harmony, contributing significantly to self-esteem.

Immediate implant placement after maxillary sinus lift using the side window technique: clinical case report / Colocação de implante imediato após levantamento de seio maxilar através da técnica de janela lateral: relato de caso clínico

Aim: The aim of this study was to report a maxillary sinus lift surgery associated with the installation of an immediate implant associated with late loading in edge with 3.5 mm in height. Methods: The sinus lift surgery was performed using the lateral window technique, followed by the immediate installation of the implant and subsequent manufacture of a screw-retained single prosthesis. Results: Through the technique of breast lift, it was possible to promote local bone formation in a vertical direction, enabling local dental rehabilitation. Conclusions: Following a solid and meticulous planning, even in crests with less than 5 mm in height, a transcrestal technique can be used predictably with an adequate clinical and radiological outcome, giving patients excellent stability of the grafted material and excellent clinical results(AU)

Objetivos: O objetivo deste estudo foi relatar uma cirurgia de levantamento de seio maxilar associada a instalação de implante imediato associado a carga tardia em rebordo com 3,5 mm de altura. Métodos: A cirurgia de levantamento de seio foi realizada através da técnica de janela lateral, seguida da instalação imediata do implante e posterior confecção de prótese unitária aparafusada. Resultados: Através da técnica de levantamento de seio, foi possível promover uma neoformação óssea local no sentido vertical, possibilitando a reabilitação dentária local. Conclusões: Seguindo um planejamento sólido e meticuloso, mesmo em cristas com menos de 5 mm de altura, a técnica de janela lateral pode ser usada de forma previsível com um resultado clínico e radiológico adequado, dando aos pacientes excelente estabilidade do material enxertado e excelentes resultados clínicos(AU)

The Italian Covid-19 Phase 2 in Piacenza: results of the first semester of 2020 and future prospective of new orthopedics surgical procedures.

INTRODUCTION: During the pandemic, Piacenza's Orthopedic and Traumatology Dep. firstly dealt with the emergency with the complete closure of all the elective surgical and outpatient activities.As general population, also healthcare workers were affected by Coronavirus, increasing difficulties of epidemic management.The aim of our study is to evaluate the activity trend of the first 6months of 2020 in our hospital.Data will be compared to the two semesters of 2019, in order to have two objective samples. MATERIALS AND METHODS: We retrospectively analyzed all the orthopedics surgical procedures performed at Guglielmo da Saliceto Hospital (Piacenza, Emilia Romagna, Northern Italy)between 1/1/20 and 30/06/20. 2019 semesters (1/01/20-30/6/20 and 1/07/20-31/12/20) have been used as control group to evaluate the activity trend of the first six months of 2020, compared to the two semesters of 2019. RESULTS: We noticed a significant increase of domestic and retirement houses accidents, a consistent increase in one-month mortality rate of 2020 first semester and a decrease of mean hospitalization time.About surgical procedures, we detect a drop in the total number: in the first semester of 2020 we performed 499 (-39.9%) surgeries less than the first semester of 2019 and 337 (-30.9%) then the second one. Traumatology recorded a decrease of 27.6% than the first semester of 2019 (-204 surgeries) and of 26.3% than the second one (-191 surgeries).Concerning orthopedic procedures, in comparison to the first semester of 2019 we registered a reduction of 57.6% (-295 surgeries) and of 40.2% to the second semester (-146 surgeries). DISCUSSION AND CONCLUSION: Covid-19 forced a reorganization of the Italian Health System that led to a clear reduction of surgical procedures performed in the orthopedic and traumatology department.The "Phase 2" can't be consider the last step of the emergency.We surely will have to get used to live with this enemy, at least until we will find an effective cure or a vaccine.

Gingival Melanin Depigmentation With Diode Laser - Case Report / Despigmentación Melánica Gingival con Láser de Diodo - Relato de Caso

ABSTRACT: The pigmented lesions of the oral cavity may be endogenous or exogenous. Endogenous lesions are benign and usually caused by melanin, and they are called gingival melanin pigmentations. Among the options for depigmenting these areas, laser therapy stands out for being a minimally invasive procedure. This study aims to report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior maxillary region, for the ablation of the pigmented tissue to improve gingival aesthetics. The patient had an aesthetic complaint of the darkened aspect of the gingiva in the anterior maxillary and mandibular portions. After local anesthesia, we started depigmentation with high-power diode laser and performed ablation from the attached gingiva toward the free marginal gingiva. The patient returned after 30 and 180 days presenting healthy gingiva and absence of melanin repigmentation. Thus, we concluded that the diode laser was a good alternative for melanin depigmentation because it is a procedure with lower morbidity and satisfactory postoperative results.

RESUMEN: Las lesiones pigmentadas de la cavidad oral pueden ser endógenas o exógenas. Las endógenas son benignas y generalmente causadas por la melanina, denominándose pigmentaciones melánicas gingivales. Entre las opciones para la despigmentación de estas regiones, se destaca la laserterapia, por ser un procedimiento poco invasivo. Este trabajo tuvo como objetivo relatar un caso clínico de la técnica de despigmentación gingival utilizando láser de diodo de alta intensidad en la región anterior de los maxilares para ablación del tejido pigmentado con la finalidad de mejorar la estética gingival. El paciente presentaba como queja estética el aspecto oscurecido de la encía en la región anterior de la maxila y de la mandíbula. Tras aplicar anestesia local, se inició la despigmentación con láser de diodo de alta intensidad, siendo que la ablación se realizó a partir de la encía insertada hacia la encía marginal libre. El paciente regresó tras 30 y 180 días, presentando encía saludable y con ausencia de repigmentación melánica. Así fue posible concluir que el láser de diodo mostró ser una buena alternativa para la despigmentación melánica, ya que se presentó como un procedimiento con menor morbidad y buen resultado postoperatorio.

The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: A randomized clinical trial.

This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.

Neoformação de papila gengival com ácido hialurônico: relato de caso

Introdução: a papila interdentária é a porção gengival que ocupa o espaço entre dois dentes adjacentes e a ausência dessa estabelece espaços interdentais denominados black spaces, causando desconforto, impacção alimentar e problemas estéticos e fonéticos. A etiologia da recessão da papila interdental é multifatorial, podendo ou não estar associada às doenças periodontais ou ao tratamento dessas. Objetivo: este estudo tem como objetivo avaliar a eficiência do ácido hialurônico como material indutivo à formação de papila gengival, visando ao preenchimento das ameias interdentais por novo tecido gengival. Relato de caso: paciente branco, 53 anos, gênero masculino, apresentando durante exame clínico perda de papila interdentária na arcada superior, abrangendo os elementos dentários 13, 12, 11, 21, 22 e 23. A saúde bucal dos demais elementos dentários estava em boas condições. Logo após exame clínico e fotografias, foram realizadas aplicações de ácido hialurônico (Perfectha Derm, Obvieline Laboratoire, France) para preenchimento do black space interpapilar. Considerações finais: o ácido hialurônico demonstrou eficácia e biocompatibilidade com os tecidos, obtendo resultados satisfatórios quanto à sua aplicação. A aplicação como material de preenchimento injetável revelou ser de grande importância para casos de grande perda de papila interdentária, demonstrando ser um mé- todo simples, seguro e eficaz.

Effectiveness of low intensity laser therapy on oral mucositis in head and neck cancer patients / Efetividade da terapia com laser de baixa intensidade em mucosite oral de pacientes com câncer de cabeça e pescoço

Introduction: About 870,000 new cases of malignant airway and digestive tract tumor are diagnosed annually worldwide. Patients undergoing radiotherapy (RT) for head and neck develop as side effects oral mucositis and other complications that can lead to discontinuation of anticancer treatment. Aim: This study was conducted to determine whether oral care can reduce the rates of discontinuation of anticancer treatment. Method: We selected patients with carcinoma of the head and neck radiotherapy with or without chemotherapy (CT) in the Hospital São Vicente de Paulo de Passo Fundo. A total of 187 patients were evaluated and divided into two groups: Group I (patients receiving dental treatment) and Group II (patients not receiving dental treatment). Group I ­ patient were submitted to daily assessments, receiving guidance, following a protocol for dental treatment and adjuvant application of low intensity laser throughout the period they performed RT. Group II - patients were evaluated and followed only, for not allowing the proposed treatment. Results: The interruption of radiation treatment was 2.4% of the patients in Group I, and Group II 34.6%. Conclusions: prevention and early treatment of complications related to RT like oral mucositis can decrease the chance of the patient to abandon radiotherapy and consequently contribute for a better prognosis for cure and patient survival (AU)

Introdução: Cerca de 870 mil novos casos de neoplasias malignas de vias aéreas e tumores do aparelho digestivo são diagnosticados anualmente em todo o mundo. Os pacientes submetidos à radioterapia (RT) de cabeça e pescoço desenvolvem efeitos colaterais como mucosite oral e outras complicações que podem levar à interrupção do tratamento anticâncer. Objetivo: Este estudo foi realizado para determinar se cuidados bucais podem reduzir as taxas de abandono do tratamento anticâncer. Método: Foram selecionados pacientes com carcinoma de cabeça e pescoço submetidos a radioterapia (RT), com ou sem quimioterapia (QT), no Hospital São Vicente de Paulo de Passo Fundo. Um total de 187 pacientes foram avaliados e divididos em dois grupos: Grupo I (pacientes que recebem tratamento dental) e Grupo II (pacientes que não receberam tratamento dental). Os pacientes do grupo I foram submetidos a cuidados diários, recebendo orientação, seguindo um protocolo de tratamento odontológico e aplicação adjuvante do laser de baixa intensidade durante todo o período que realizaram RT. Os pacientes do grupo II foram avaliados odontologicamente e acompanhados somente. Resultados: A interrupção do tratamento com radiação foi de 2,4% dos pacientes do Grupo I e no Grupo II 34,6%. Conclusões: a prevenção e o tratamento precoce das complicações relacionadas com a RT, como mucosite oral, podem diminuir a chance de o paciente abandonar a radioterapia e, consequentemente, contribuir para um melhor prognóstico de cura e sobrevida dos pacientes (AU)

Tratamento do sorriso gengival com toxina botulínica tipo A: relato de caso / Treatment of gummy smile using botulinum toxin type A: case report

Objetivo: o sorriso é a mais bela das expressões faciais e está diretamente relacionado com bem-estar, felicidade, prazer entre outros. Fisiologicamente é o resultado da exposição dos dentes e da gengiva durante a contração de um grupo muscular. Muitas pessoas ao sorrir mostram uma quantidade excessiva de gengiva, o que constitui um problema estético. Assim, este artifo apresenta uma revisão de literatura a respeito da etiologia e do tratamento do sorriso gengival, bem como, relata por meio de caso clínico a indicação da toxina botulínica como modalidade de tratamento para esse. Relato de caso: paciente do sexo feminino, 22 anos, com sorriso gengival causado por hipermobilidade dos músculos elevadores do lábio superior, exposição gengival bilateral de 4 mm. Foi tratada com 10U bilaterais de toxina botulínica tipo A que resultou em um sorriso harmônico e esteticamente mais agradável. Considerações finais: o sorriso gengival é considerado uma desordem estética por muitos pacientes e pode ser tratado por meio da utilização da toxina botulínica.

Dispositivos de fixação nas fraturas mandibulares: relato de caso / Fixation devices in fractures of the jaw: case report

Este estudo objetiva relatar um caso clínico de paciente com fratura mandibular submetido a cirurgia bucomaxilofacial, ressaltando os métodos e dispositivos utilizados no procedimento. Relato de caso: paciente masculino, 20 anos de idade, leucoderma, procurou o Serviço de Emergência do Hospital São Vicente de Paulo da cidade de Passo Fundo, RS, Brasil, apresentando traumatismo facial por agressão física em região ântero-inferior da cabeça, correspondendo à região parassinfisiária mentual. A telerradiografia de perfil mostrou fratura composta horizontal desfavorável em corpo de mandíbula direito, desde a base da mandíbula até a região alveolar dentária, entre os dentes 42 e 43. Foi realizada intervenção cirúrgica para correção dos fragmentos ósseos, preservando-se a estética do paciente. Para estabilização dos fragmentos ósseos, utilizaram-se placas de titânio fixadas por parafusos, além de bloqueio intermaxilar. Acompanhamento clínico e radiográfico de 30 dias mostrou adequada consolidação das linhas de fratura. Considerações finais: um correto diagnóstico seguido de procedimento cirúrgico e estabilização adequada das porções fraturadas permitiram sucesso no tratamento da fratura mandibular do paciente em questão...

This report aims to report a clinical case with mandibular fracture underwent maxillofacial surgery, highlighting the methods and devices used in the procedure. Case report: male patient, 20 years old, caucasian, came to the Emergency of Hospital São Vicente de Paulo in the city of Passo Fundo, RS, Brazil, with facial trauma by physical aggression in the lower anterior region of the head, corresponding the chin region. The profile radiograph showed unfavorable horizontal compound fracture in right mandibular body, from the base of the mandible to the dental alveolar region, between the teeth 42 and 43. Surgery was performed to correct bone fragments, preserving the aesthetics of the patient. To stabilize the bone fragments were used titanium plates fixed by screws and the intermaxillary block. Clinical follow-up of 30 days showed adequate radiographic consolidation of fracture lines. Final remarks: a correct diagnosis followed by surgical procedure and adequate stabilization of the fractured portions allowed success in the treatment of mandibular fracture of the patient...

Aplicações da toxina botulínica em odontologia / Applications of botulinum toxin in dentistry

Apresentar uma revisão de literatura sobre a utilização da toxina botulínica (BTX) na odontologia. Revisão de literatura: a BTX é produzida por uma bactéria anaeróbia denominada Clostridium botulinum e proporciona melhorias na qualidade de vida dos pacientes, uma vez que pode ser aplicada no tratamento das desordens dolorosas crônicas, tornando-se eficaz no tratamento do bruxismo, cefaleia tensional, sorriso gengival, distúrbios temporomandibulares e sialorréia. Após a normatização da utilização da BTX no Brasil, a mesma passou a ser rotina nos consultórios odontológicos também com finalidade estética, visando atenuar as pregas e linhas de expressão do rosto, uma vez que promove o relaxamento da musculatura facial, tornando a expressão menos contraída. Considerações finais: a BTX tem se tornado um produto de escolha para tratamento de distintas disfunções no meio odontológico, muito embora o cirurgião-dentista precise estar ciente de sua ação segura sobre as diversas estruturas anatomofuncionais envolvidas...

To present a literature review about the use of botulinum toxin (BTX) in dentistry. Literature review: BTX is produced by an anaerobic bacterium called Clostridium botulinum and provides improvements in the quality of life of patients, since it can be applied in the treatment of chronic pain disorders, becoming effective in the treatment of bruxism, tension headache, gummy smile, temporomandibular disorders and drooling. After the normalization of the use of BTX in Brazil, it became routine in the dental office also with aesthetic purpose, to mitigate the folds and facial expression lines, as it promotes relaxation of the facial muscles, producing a less contracted expression. Final considerations: BTX has become a product of choice for the treatment of different disorders in the dental environment, although the dentist need to be aware of their safe action on the various anatomical structures involved...

Sialólito de glândula salivar submandibular: relato de caso / Sialolith of submandibular salivary gland: case report

Objetivo: ilustrar um caso de sialolitíase localizado na glândula submandibular. A sialolitíase está entre as enfermidades mais comuns das glândulas salivares. Apresenta crescimento lento, é uma patologia benigna, mas de etiologia incerta. A maioria dos casos ocorre no ducto de glândula submandibular, devido ao trajeto do ducto de Wharton que é sinuoso e ascendente, com maior facilidade para deposição dos sais de cálcio e consequente formação de cálculos, além da maior quantidade de proteínas secretadas pela glândula submandibular, o que torna a secreção mais espessa. O diagnóstico é feito por meio da avaliação intra e extraoral, além do auxílio de exames complementares, tais como radiografia, ultrassonografia, tomografia computadorizada (TC) e sialometria. O tratamento está intimamente ligado ao tamanho e à localização do cálculo e sempre se opta, quando possível, pelo mais conservador. Relato de caso: paciente do gênero feminino, leucoderma, 53 anos, portadora de um sialólito no ducto da glândula submandibular do lado esquerdo. Foi realizado tratamento cirúrgico, por acesso intraoral, na região do ducto obliterado, mantendo a glândula afetada em funcionamento. A paciente foi acompanhada por seis meses após a remoção do sialólito sem recidivas ou intercorrências pós-operatórias. Considerações inais: de acordo com o caso ilustrado neste trabalho e o que foi observado na literatura revisada, sialólito é uma calcificação que ocorre nos ductos das glândulas salivares, de origem idiopática, com tamanho e localização variados. Nesse sentido, o tratamento de escolha inicial para a remoção de sialólito deve ser conservador, optando-se por excisão cirúrgica quando o primeiro não for possível, e em casos extremos excisão da glândula afetada. O diagnóstico precoce é imprescindível devido à sintomatologia dolorosa e o desconforto.

Mioepitelioma pré-auricular: revisão de literatura e relato de caso / Mioepitelioma pré-auricular: revisão de literatura e relato de caso

Objetivo: este trabalho visa demonstrar, por meio de relato de caso e revisão de literatura, o comportamento do mioepitelioma benigno. Considerado um tumor raro das glândulas salivares, possui crescimento lento, mui-tas vezes assintomático, cuja incidência é praticamen-te igual entre os sexos, podendo ter ligeira predileção pelas mulheres. Pode ocorrer em várias faixas etárias, sendo mais comum por volta dos 50 anos. A glândula parótida e o palato são os locais de predileção desse tumor que pode variar de 1 a 5 cm, geralmente en-capsulado, indolor, bem delimitado, e com coloração esbranquiçada. O principal diagnóstico diferencial do mioepitelioma é o adenoma pleomórfico. Histologica-mente, o mioepitelioma benigno é composto por célu-las mioepiteliais e o tratamento constitui-se de remoção cirúrgica da lesão com baixa taxa de recidiva após sua remoção completa. Relato de caso: este trabalho rela-tou um caso clínico de mioepitelioma benigno locali-zado em região pré-auricular, removido cirurgicamente e acompanhado por oito anos, sem sinais de recidiva, bem como as características clínicas e microscópicas dessa enfermidade. Considerações finais: embora raros, tumores como o mioepitelioma podem ser encontrados nas avaliações clínicas de rotina. Cabe ao cirurgião--dentista realizar uma inspeção completa da face do paciente, compreendendo todo o sistema estomatogná-tico e as estruturas adjacentes dentro dos critérios da semiologia. Quanto mais precoce o diagnóstico dessas patologias, melhor o seu prognóstico de tratamento.

Síndrome de gorlin-goltz ? relato de casos / Gorlin-Goltz syndrome ? cases report

Objetivo: este trabalho faz uma revisão de literatura sobre Síndrome de Gorlin-Goltz, citando as diversas manifestações clínicas dessa síndrome, bem como, relata dois casos clínicos de pacientes portadores e os planos de tratamento clínico e cirúrgico propostos para cada caso. Revisão de literatura: a Síndrome de Gorlin--Goltz, também conhecida como Síndrome do Carci-noma Nevóide de Células Basais ou Síndrome do nevo basocelular, é uma desordem autossômica dominante hereditária, com alta penetrância e expressividade fe-notípica variável, que foi primeiramente definida como uma tríade principal de múltiplos carcinomas basocelu-lares, tumores odontogênicos ceratocísticos e anoma-lias esqueléticas. Considerações finais: o diagnóstico e o tratamento desta síndrome requerem uma abordagem multidisciplinar por dermatologistas, cirurgiões buco-maxilofaciais, neurologistas e neurocirurgiões.

Effectiveness of high-power diode laser associated to chemical auxiliary substance on decontamination of root canal system infected with Enterococcus faecalis ? an in vitro study

Objective: to evaluate the additional antibacterial ac-tion of high-power diode laser after the use of 2.5% sodium hypochlorite and 2% chlorhexidine gel in root canals infected with E.faecalis. Materials and method: 120 human teeth with single canal were inoculated with E.faecalis for 14 days and randomly divided into six groups (n=20), according to the chemical auxiliary substance used in the chemo-mechanical preparation and the use of high-power diode laser: G1(NaOCl) ? root canal preparation with 2.5% sodium hypo-chlorite; G2(CHX) ? root canal preparation with 2% chlorhexidine gel; G3(NaOCl+DL) - root canal pre-paration with 2.5% sodium hypochlorite+diode la-ser; G4(CHX+DL) - root canal preparation with 2% chlorhexidine gel+diode laser; G5(NaCl+DL) - root canal preparation with 0.9% saline solution+diode la-ser; G6(no treatment) ? no treatment was performed. Microbiological test (CFUs counting) was performed to evaluate the effectiveness of proposed treatments. Data were subjected to One-way ANOVA followed by post-hoc Tukey test (?=0.05). Results: G3(NaOCl+DL) had reduction of 99.42% of E.faecalis, followed by G4(CHX+DL) ? 93.48%; G1(NaOCl) ? 89.82%; G2(CHX) ? 81.86%; G5(NaCl+DL) ? 65.40%; and G6(no treatment) ? no reduction. There was significant statistical difference in CFUs of all groups in relation to G6(no treatment) (p<0.05). G1(NaOCl), G2(CHX), G3(NaOCl+DL) and G4(CHX+DL) were statistically superior to G5(NaCl+DL) (p<0,05). Conclusion: High--power diode laser, when associated with 2.5% NaOCl or 2% CHX, improves the antimicrobial effect of these substances in the root canals infected with E. faecalis.

Laser cirúrgico no tratamento de hiperplasia fibrosa / Surgical laser on fibrous hyperplasia treatment

Objetivo: demonstrar, por meio de relato de caso clínico, a exérese de uma hiperplasia fibrosa inflamatória (HFI) com o uso de laser cirúrgico de diodo. Relato de caso: paciente leucoderma, gênero masculino, 48 anos, compareceu ao Ambulatório de Especialidades do SUS do Hospital São Vicente de Paulo, Passo Fundo/ RS, apresentando ausência do elemento dentário 46 e lesão nodular exofítica, pediculada, coloração rósea, superfície lisa em mucosa jugal medindo aproximadamente 2 cm, ocupando o espaço do elemento ausente, com histórico de 6 anos, sem queixa álgica no local. O tratamento proposto foi a remoção cirúrgica com laser de diodo, seguindo protocolo sugerido pelo fabricante. Sob anestesia infiltrativa local, realizou-se a excisão da lesão com incisão uniforme pela base. A peça cirúrgica foi fixada em formol 10% e encaminhada para exame anatomopatológico. O exame histopatológico apresentou como diagnóstico fibroma de irritação. Considerações finais: o uso de laser cirúrgico de diodo é um método seguro e eficaz, além de apresentar inúmeras vantagens quando comparado com a técnica convencional para excisões cirúrgicas de lesões de tecidos moles na cavidade oral. A remoção cirúrgica da HFI com pequena margem de segurança e remoção do fator etiológico constitui uma terapêutica satisfatória; a amostra deve sempre ser enviada para análise anatomopatológica, para confirmar o diagnóstico. O cirurgião-dentista deve ter conhecimento específico para operação e indicação do uso do laser cirúrgico.

Objective: to demonstrate through a clinical case report the excision of an inflammatory fibrous hyperplasia (IFH) with the use of surgical diode laser. Case report: male leucoderma patient, 48 years old, sought assistance on the Specialty Outpatient Clinic of SUS (Unified Health System) of the Hospital São Vicente de Paulo, in the city of Passo Fundo / RS - Brazil, lacking tooth 46 and with nodular exophytic lesion, pedunculated, with a pinkish color and smooth surface, on the buccal mucosa measuring approximately 2 cm and occupying the space of the missing element. The patient had a history of 6 years without pain complaint on site. The proposed treatment was surgical removal with diode laser, following manufacturer's suggested protocol. Under local infiltrative anesthesia, an excision of the lesion with uniform incision at the base was made. The surgical specimen was fixed in 10% formaldehyde and sent for pathological examination. Histopathological examination presented fibroma irritation as diagnosis. Final considerations: the use of surgical diode laser is a safe and effective method, and presents numerous advantages compared to the conventional technique for surgical excisions of soft tissue lesions in the oral cavity. Surgical removal of IFH with small safety margin, and removal of the etiologic factor is a satisfactory therapy. The sample should always be sent for pathological examination to confirm the diagnosis. The dentist must have specific knowledge to operate and recommend the use of surgical laser.