Osteoradionecrosis in a Torus Mandibularis Treated by Antimicrobial Photodynamic Therapy: A Case Report.

Background: Osteoradionecrosis (ORN) of the jaws is a late complication after radiotherapy to head and neck cancer. Objective: To describe a rare case of ORN of the torus mandibularis that was successfully managed exclusively with antimicrobial photodynamic therapy (aPDT). Case report: A 72-year-old man presented an exposed necrotic bone observed in the torus mandibularis, extending to the lingual alveolar ridge with no edema nor suppuration. The treatment provided a noninvasive treatment leading to spontaneous sequestrectomy of the torus in 2 weeks with complete mucosal repair in 5 weeks and absence of lesion signs and/or symptoms even after 6 months of follow-up. Conclusions: The aPDT indicated to be a satisfactory treatment for ORN affecting torus mandibularis, a region with surgical limitations, avoiding surgery.

Effect of ozone therapy on wound healing in the buccal mucosa of rats.

OBJECTIVE: The objective of this study was to evaluate the effects of ozone therapy on wound healing formed experimentally in the oral cavity of rats. DESIGN: Two surgical wounds were generated on the cheeks of 24 Wistar rats, bilaterally. Half of the animals were submitted to ozone therapy on both wounds (experimental group) and the other half received no treatment (control group). In the experimental group, wounds were exposed to ozone gas 1, 2 or 3 (60 µg/mL) times. Evaluation of wound healing of the buccal mucosa was followed for 1, 3 and 7 days. The distribution of neutrophils, fibroplasia and angiogenesis were analyzed. Samples were classified in a healing numerical scale according to the inflammatory intensity. Data were submitted to Mann-Whitney and Kruskal-Wallis tests (α = 0.05). RESULTS: On day 1, wounds were similar in both groups, lesions were open and bloody with slightly minor bleeding in the ozone therapy group. On day 3, the group with ozone therapy was almost all refurbished and with higher angiogenesis, while the control group still had more bloody points and lower blood vessels. On day 7, both wounds were remodeled, with higher fibroplasia in the group that received ozone therapy. CONCLUSION: It can be concluded that ozone therapy was effective in improving angiogenesis and fibroblasts count in the buccal mucosa of rats.

In Situ Melanoma of the Gingiva Associated with Dense Inflammation and Pigment Deposition: A Potential Diagnostic Pitfall in Evaluating Stromal Invasion.

Melanoma is a highly aggressive neoplasm in which the neoplastic cells display melanocytic differentiation. Less than 1 % of all melanomas arise in the mucosal surfaces of the oral cavity, with purely in situ lesions being exceedingly rare tumors, but with a favorable prognosis compared with invasive lesions. We describe the clinical, histopathological and immunohistochemical findings in an uncommon case of in situ mucosal melanoma of the oral cavity with intense tumor-associated pigment deposition and inflammation complicating the morphological assessment of infiltrative areas.

Peripheral ameloblastoma with dystrophic calcification: an unusual feature in non-calcifying odontogenic tumors.

Peripheral ameloblastoma is a rare extraosseous counterpart of central ameloblastoma that occurs in soft tissues and may cause bone crest resorption. This study reports a peripheral ameloblastoma on the buccal gingiva of a 56-year-old man, which presented extensive squamous metaplasia areas, keratinization and dystrophic calcifications in the neoplastic islands. It is emphasized the need of a detailed imaging study and a long follow-up period to exclude bone involvement whenever peripheral ameloblastoma diagnosis is considered.

Peripheral Ameloblastoma with Dystrophic Calcification: An Unusual Feature in Non-Calcifying Odontogenic Tumors

Peripheral ameloblastoma is a rare extraosseous counterpart of central ameloblastoma that occurs in soft tissues and may cause bone crest resorption. This study reports a peripheral ameloblastoma on the buccal gingiva of a 56-year-old man, which presented extensive squamous metaplasia areas, keratinization and dystrophic calcifications in the neoplastic islands. It is emphasized the need of a detailed imaging study and a long follow-up period to exclude bone involvement whenever peripheral ameloblastoma diagnosis is considered.

Ameloblastoma periférico é a contraparte rara extraóssea do ameloblastoma central, que ocorre em tecidos moles e pode causar reabsorção da crista óssea. Este estudo reporta um ameloblastoma periférico localizado na gengiva vestibular de um homem de 56 anos de idade, que apresentava extensas áreas de metaplasia escamosa, queratinização e calcificação distrófica dentro das ilhas neoplásicas. É enfatizada a necessidade de um estudo de imagem detalhado e acompanhamento prolongado para excluir envolvimento ósseo sempre que o diagnóstico de ameloblastoma periférico for considerado.

Expressão imuno-histoquímica das proteínas Jab1, p27, c-jun e c-fos no adenoma pleomórfico, adenocarcinoma polimorfo de baixo grau e carcinoma adenoide cístico das glândulas salivares / Immunohistochemistry expression of Jab1, p27, c-jun and c-fos proteins in pleomorphic adenoma, low grade polymorphous adenocarcinoma and adenoid cystic carcinoma of the salivary glands

Os tumores de glândula salivar compreendem em torno de 2 a 6,5% dos tumores de cabeça e pescoço. Entre os tumores de glândula salivar, o adenoma pleomórfico é benigno e o mais comum. O carcinoma adenoide cístico e adenocarcinoma polimorfo de baixo grau encontram-se entre os mais frequentes malignos. Jab1 é uma de muitas proteínas que afetam diversos estágios da tumorigênese sendo importante na regulação variadas vias de sinalização e/ou proteínas como p27 e AP-1, a última composta por c-jun e c-fos, que são principalmente relacionadas com o ciclo celular e proliferação celular. O objetivo desse trabalho foi avaliar a expressão imuno-histoquímica das proteínas Jab1, p27, c-jun e c-fos no adenoma pleomórfico, adenocarcinoma polimorfo de baixo grau e carcinoma adenoide cístico das glândulas salivares. Foi realizada análise imuno-histoquímica semi-quantitativa das células marcadas nos tumores de glândula salivar e glândula salivar normal de acordo com o escore 0 (células sem expressão), 1(> 0 <= 5% de células marcadas), 2 (> 5 <= 50%) and 3 (> 50%). Para Jab1, c-jun e c-fos foi considerado apenas marcação nuclear e para p27, nuclear e citoplasmática, separadamente. Os resultados foram analisados utilizando-se os testes de Kruskal-Wallis, de Mann-Whitney, do Qui-quadrado e o teste de correlação de Spearman, cujo nível de significância foi de p<0,05 e processados com o auxílio do software GraphPad Prisma 5.0...

Salivary gland tumors comprise about 2 to 6.5% of the head and neck tumors. Among the salivary gland tumors, pleomorphic adenoma is the most common and benign tumor. Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma are the most frequent malignant tumors. Jab1 is one of many proteins which affects many stages of the tumorigenesis and regulates positively and negatively several pathways and/or proteins such as p27 and AP-1, the latter composed by c-jun and c-fos, which are mostly related to cell cycle and cell proliferation. The aim of this study was to evaluate the immunoexpression of the proteins Jab1, p27, c-jun and c-fos in pleomorphic adenoma, polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma of the salivary glands. The semi-quantitative immunohistochemical analysis was performed in salivary gland tumors and in normal salivary gland according to the score 0 (no stained cells), 1 (> 0 <= 5% of stained cells), 2 (> 5 <= 50%) and 3 (> 50%)...

Avaliação do status das glândulas salivares parótida e submandibular na displasia ectodérmica hipoidrótica por meio da ultrassonografia / Evaluation of the status of the parotid and submandibular salivary glands in the hypohidrotic ectodermal dysplasia by ultrasonography

Displasia ectodérmica hipoidrótica é uma doença genética rara, clinicamente caracterizada por alterações envolvendo os dentes, pele e suas estruturas anexas. Manifestações orais comuns incluem anadontia ou oligodontia, dentes conóides e xerostomia. Poucos relatos associam displasia ectodérmica e redução do fluxo salivar. O objetivo desse estudo é analisar possíveis alterações nas glândulas salivares de dez portadores de displasia ectodérmica que fazem acompanhamento no Departamento de Dermatologia Pediátrica da Universidade de São Paulo. Ultrassonografia foi realizada em dez casos em infantes portadores de displasia ectodérmica hipoidrótica nas suas glândulas salivares parótida e submandibular. Três apresentaram alterações na glândula parótida e/ou submandibular. Aplasia ou hipoplasia das glândulas salivares maiores é associada a casos de displasia ectodérmica e sugere-se acompanhamento rotineiro das glândulas salivares maiores usando ultrassonografia para prevenção de alterações decorrentes da hiposalivação na cavidade oral

Background- Hypohidrotic ectodermal dysplasia is a rare genetic disease, clinically characterized by defects involving skin and their adnexal structures, as well as oral structures such as teeth, and occasionally salivary glands. These latter manifestations include anodontia or hypodontia, conical teeth and xerostomia. Objective- To analyze possible alterations in major salivary glands of ten patients with ectodermal dysplasia, using image exam. Methods- Ultrasonography was performed in ten pediatric cases of hypohidrotic ectodermal dysplasia to investigate the status of parotid and submandibular salivary gland. Results- Three patients presented aplasia/hypoplasia of at least one gland examined. The other 7 patients did not present any alterations in parotid and submandibular glands. Limitations- Although ultrasonography exam is adequate to investigate the presence and status of major salivary glands, other important glands such as sublingual and minor mucous salivary glands are not well-visualized using this technique. Conclusions- Aplasia or hypoplasia of the major salivary gland is strongly related to ectodermal dysplasia and we suggest routine evaluation of the major salivary gland using ultrasound to monitor and manage the possible impact of xerostomia in oral health