Effect of Treatment with Selective Caries Removal Associated to Antimicrobial Photodynamic Therapy on Children's Oral Health-Related Quality of Life: A Non-Randomized Clinical Study.

How patients perceive impact of diseases is an essential component when characterising different disease impacts, and effects of dental treatments should be perceived by the patients. This study aimed to assess the impact of conservative treatment of deep caries lesions using the selective caries removal (SCR) associated to a low laser therapy (antimicrobial photodynamic therapy-aPDT) on oral health-related quality of life (OHRQoL). STUDY DESIGN: A non-randomized clinical before-and-after study was conducted on children aged 4 to 8 years. The data was obtained applying the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) to the caretakers in an interview before and after treatment. The paired T-student test considering p<0.05 and the treatment responsiveness detecting the effect size by means of standardized response mean (SRM) was evaluated. RESULTS: The mean impact on OHRQoL on the total scale was 5.46 ± 4.54 for before and 2.42 ± 3.54 for after treatment (p<0.01). The ECOHIS demonstrated satisfatory longitudinal responsiveness except for psychological, self-image/social interaction and Family function domain (SRM<0.5). CONCLUSION: This study demonstrated that the association of a low laser therapy (aPDT) with SCR did not influence negatively on OHRQoL. In the practice of pediatric dentistry, this conservative dental treatment improved the OHRQoL after 3 months of follow up.

Peripheral giant cell granuloma associated with a dental implant.

BACKGROUND: Peripheral giant cell granuloma (PGCG) is an uncommon pathology that affects gingival or alveolar mucosa. Although PGCG can be associated with dental implants, little is known about this lesion and implant osseointegration as well as its etiopathogenesis and the treatments available. This study sought to report a rare case of PGCG associated with dental implant, emphasizing its clinical and histopathological aspects. CASE PRESENTATION: A 53-year-old man had an exophytic, reddish lesion, around a crown attached to a dental implant located in the left mandible. Radiographically, there was bone loss around the implant. After excisional biopsy, histological examination revealed a submucosal proliferation of multinucleated giant cells rendering the diagnosis of peripheral giant cell granuloma. Patient has been under follow-up for 6 months with no recurrence. CONCLUSIONS: Peri-implant lesions must be completely removed to prevent recurrence of PGCG and implant failure, even in cases suspected to be reactive. Besides, histological examination must be performed on all peri-implant reactions to achieve the appropriate diagnosis and, consequently, the best treatment and follow up.

Usefulness of tissue autofluorescence imaging in actinic cheilitis diagnosis.

Actinic cheilitis (AC) is a potentially malignant disorder of the lips. Because of its heterogeneous clinical aspect, it is difficult to indicate representative biopsy area. The purpose of this study was to evaluate the usefulness of tissue autofluorescence in AC diagnosis. The system was composed of a 405-nm light-emitting diode, sent to the sample by a dichroic, that allows the fluorescence signal to reach a camera directly plugged in the system. Fifty-seven patients with clinical diagnosis of AC and 45 normal volunteers were selected. According to clinical and fluorescence features, one or more areas were selected for biopsies in the AC group and epithelial dysplasia (ED) grades were established. The autofluorescence images were processed by a clustering algorithm for AC automated diagnosis. The tissue autofluorescence image revealed a heterogeneous pattern of loss and increase of fluorescence in patients with AC. ED was found in 93% of the cases, and most of the areas graded as moderate or severe ED were chosen with the aid of autofluorescence. The processed autofluorescence images from AC patients showed a higher number of spots in an irregular pattern. Tissue autofluorescence image system is a useful technique in association with clinical examination for AC diagnosis.