RESUMO
Benign fibro-osseous lesions with cystic degenerations have been scarcely reported in craniofacial bones and its unusual characteristics pose a diagnostic challenge. Here, we report a case of craniofacial fibrous dysplasia presenting a large cystic degeneration. A 55-year-old woman had a history of pain, slight asymmetry on the zygomatic region and ocular pressure. Computed tomography revealed on the right side, multiple craniofacial bones showing a ground glass aspect, associated with an extensive hypodense, unilocular, well circumscribed lesion in the maxilla, and smaller lesions in the sphenoid bone. After a surgical procedure performed in another service, there was a complete improvement in symptoms, and after 1 year, the patient remains stable, with no changes. In the literature review, thirty-three reported cases of the same association in the craniofacial region were found. The main symptoms were sudden increase in the lesion and pain, and the indication of intervention in cystic lesions was only indicated in symptomatic cases or functional deficit. The knowledge of the possibility of the association of benign fibro-osseous lesions and cystic degenerations in craniofacial bones is essential to perform a correct diagnosis and treatment for these patients, consequently avoiding unnecessary procedures. Key words:Craniofacial fibrous dysplasia, Fibrous dysplasia, Benign fibro-osseous lesions, Cystic degeneration.
RESUMO
To describe a case of unilateral TMJ osteoarthritis from the Dentistry point of view, aiming to restore the quality of life through non-invasive procedures. Description of case: M.C.B., female,69 years, complaining about a sudden change in the bite, difficulty to chewing/opening mouth and pain in the orofacial region. At extraoral examination, we observe the presence of crepitus in the left TMJ,click in the right TMJ (electrovibratography) and pain on palpation in the left TMJ region. Absence of tooth contacts on the right side in maximum habitual intercuspation (MHI). The intraoral examination revealed the presence of inflammation and excessive wear in the left mandibular condyle(osteoarthritis), visualized by computed tomography and magnetic resonance imaging with contrast. The patient underwent treatment by oclusal splint (night use), overlay removable partial dentures (day time use), application of lower level laser therapy and transcutaneous electrical nervous stimulation (TENS). Masticatory function, mouth opening, and aesthetics improved. Conclusion: Conservative therapies maybe a good option for the re-establishment of the quality of life in subjects with TMJ osteoarthritis, in as much as it can postpone or delete the indication of more invasive techniques (e.g. surgery)...
Descrever um caso de osteoartrite da ATM unilateral do ponto de vista Odontológico, com o objetivo de restaurar a qualidade de vida através de procedimentos não invasivos. Descrição do caso: M.C.B., do gênero feminino, 69 anos, com queixa principal de mudança repentina na mordida, dificuldade de mastigação e dor na região orofacial durante a abertura bucal. Ao exame físico, observamos a presença de crepitação na ATM esquerda, estalidona ATM direita (eletrovibratografia) e dor à palpação da região da ATM esquerda. Ausência de contatos dentais no lado direito em intercuspidação habitual máximo (MHI). O exame intraoral revelou a presença de inflamação e desgaste excessivo no côndilo mandibular esquerdo (osteoartrite),visualizado pela tomografia computadorizada e ressonância magnética com contraste. O paciente foi submetido a tratamento por placa oclusal (uso noturno) e prótese parcial removível (uso durante o dia), aplicação de laserterapia de baixa intensidade e estimulação nervosa elétrica transcutânea (TENS).Houve melhora na função mastigatória, a abertura bucal, e estética. Conclusão: terapias conservadoras podem ser uma boa opção para o restabelecimento da qualidade de vida em indivíduos com osteoartrite da ATM, na medida em que pode adiar ou eliminara indicação de técnicas mais invasivas (por exemplo,cirurgia)...
Assuntos
Humanos , Osteoartrite , Articulação TemporomandibularRESUMO
BACKGROUND: Solitary fibrous tumors of the orbit are uncommon lesions, only one relatively large series having been published. Neoplasms, formerly considered as separate entities, including hemangiopericytoma, are presently encompassed as solitary fibrous tumors, a unifying designation. There is a tendency towards recurrence and some cases are malignant. Their rarity justifies the publication of new cases, in order to increase the amount of information about this pathological entity. CASE REPORT: A 40-year-old female patient developed swelling in the left lower lid and after slow progression of the symptom during 2 years, presented herself to our elective surgery service. Image exams showed a 20-mm encapsulated tumor. Surgical treatment was performed: complete excision, made difficult by the growth of the lesion amid the inferior rectus and inferior oblique muscles. Histopathological and immunochemical examinations with CD34 positivity, diagnosed a solitary fibrous tumor, without suggestive signs of malignancy. After a follow-up of 40 months, no recurrence has been detected. DISCUSSION: Solitary fibrous tumors, though uncommon, should be considered in the differential diagnosis of orbital expansive lesions. The key point to diagnosis is finding CD34 positivity in immunohistochemical examination. Such tumors have a tendency for recurrence, even after more than 5 years.
