Supragingival and subgingival microbiota from patients with poor oral hygiene submitted to radiotherapy for head and neck cancer treatment.

OBJECTIVE: This case-control study aimed to evaluate the effects of conventional radiotherapy (RT) on the prevalence and populations of oral microorganisms in head and neck cancer patients who did not receive adequate preventive dental care. It was hypothesized that side effects of radiotherapy could be associated with radiation dose, microbiological aspects, and socioeconomic conditions of the patients. DESIGN: Twenty-eight dentate patients with head and neck cancer submitted to RT were included in the study. Radiation dose received varied from 4320 to 7020 cGy. Patients with the same demographic and health conditions, but no history of cancer or antineoplastic treatment were used as controls. Clinical examinations were carried out before RT, 15-22 days after starting RT, immediately after and 6 months after RT. Supra and subgingival biofilms were collected and cultivated onto selective and non-selective media. Isolates were identified by biochemical and physiological characteristics. Stimulated and unstimulated salivary flow rate and saliva buffer capacity were also determined. RESULTS: Mucositis, dermatitis, xerostomia, dysgeusia, dysphagia and candidiasis were common after starting RT and during the treatment period. Xerostomia was followed by a decrease in salivary pH and buffer capacity, which showed association with the increase of cariogenic cocci and yeast populations, which were also associated with deterioration of hygiene. Candida and family Enterobacteriaceae showed increased prevalence with RT, and were associated with the occurrence of mucositis and xerostomia. CONCLUSIONS: Modifications in oral biofilms of irradiated patients showed association with xerostomia and hygiene conditions, which reinforces the necessity of improving patient compliance to oral health care programs.

Epidermoid Cyst: Clinical and Surgical Case Report.

The epidermoid cyst is a development cyst, skin, filled with keratin and imprisoned by stratified squamous epithelium similar to skin. They are more frequent in males. Clinically presenting as flabby, prevalent over the face, neck and back. They are usually asymptomatic and its etiology is directly linked to trauma, as well as the imprisonment of epithelial rests during embryonic fusion. This study aims to present a case report of a patient 54 years old, with an epidermal cyst in the face, which was treated surgically.

Osteonecrose dos maxilares associada ao uso de bisfosfonato / Osteonecrosis of the jaws associated with the use of bisphosphonate

Os bisfosfonatos são eficazes na prevenção e tratamento de doenças ósseas onde há uma excessiva atividade osteoclástica, incluindo doença de Paget, Osteoporose, Osteogênese imperfeita, Displasia fibrosa, Mieloma Múltiplo, metástases ósseas de neoplasias de pulmão, mama e próstata. Necrose avascular dos maxilares é cada vez mais reconhecida como uma complicação séria da terapia à longo prazo com bisfosfonatos. O efeito antiangiogênico do bisfosfonato e sua capacidade de causar necrose óssea avascular foram bem reconhecidos. Porém o tratamento ainda se mantém polêmico. Objetivo: o objetivo do presente trabalho foi realizar uma revisão bibliográfica a respeito da osteonecrose associada ao uso de bisfosfonatos, abordando também suas características clínicas e radiográficas, etiopatogenia, tratamento e prevenção. Conclusão: embora alguns protocolos de tratamento tenham sido criados, os mesmo não são consensuais no meio profissional, sendo assim, o foco deve ser a prevenção e divulgação da osteonecrose dos maxilares associada ao uso dos bisfosfonatos..

Introduction: bisphosphonates are effective in the prevention and treatment of bone diseases where there is an excessive osteoclast activity, including Paget`s disease, osteoporosis, osteogenesis imperfecta, fibrous dysplasia, multiple myeloma, bone metastasis from cancers of the lung, breast and prostate. Avascular necrosis of the jaws is increasingly recognized as a serious complication of long-term therapy with bisphosphonates. The antiangiogenic effect of bisphosphonates and their ability to cause avascular bone necrosis were well recognized. However, this treatment still remains controversial. Objective: the objective of this study was to review literature regarding osteonecrosis associated with bisphosphonates also addressing their clinical and radiographic features, pathogenesis, treatment and prevention. Conclusion: despite the use of some protocols to treat osteonecrosis associated with bisphosphonates, one should focus on the prevention and dissemination of information on this complication...