Ana Cláudia Amorim Gomes

Sensitivity and Specificity of Pantomography to Predict Inferior Alveolar Nerve Damage During Extraction of Impacted Lower Third Molars

PURPOSE The purpose of the study was to assess the sensitivity and specificity of maxillary radiographic image findings in predicting nerve lesions in third molar surgery. PATIENTS AND METHODS A total of 260 third molars were assessed prior to surgical removal by means of panoramic radiography in the sample of 153 patients (73.8% female). The tooth root was classified according to the presence or absence of a radiological sign of a close relationship with the mandibular canal. Of the 260 cases assessed, the presence of a radiological sign of a close relationship with the mandibular canal was recorded in 159 cases. RESULTS Of the 260 cases, 9 (3.5%) presented postsurgical sensory complications. Though this percentage was higher among those in which there was judged to be a radiological sign of a close relationship with the mandibular canal than in those without such a sign, no significant association was shown to exist between the presence of the radiological sign and postsurgical changes in the inferior alveolar nerve (P = .94). The positive and negative predictive values were 0.03 and 0.97, respectively. Calculations on the results of the radiological examination in relation to the frequency of nerve lesions yielded values of 66% for sensitivity and 39% for specificity. CONCLUSIONS Panoramic radiography does not provide the reliable images required for predicting nerve lesions in third molar surgery.

Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables.

Objective: This paper investigates the relationship between preoperative findings and short-term outcome in third molar surgery. Study design: A prospective study was carried out involving 80 patients who required 160 surgical extractions of impacted mandibular third molars between January 2009 and December 2010. All extractions were performed under local anesthesia by the same dental surgeon. Swelling and maximal inter-incisor distance were measured at 48 h and on the 7th day postoperatively. Mean visual analogue pain scores were determined at four different time periods. Results: One-hundred eight (67.5%) of the 160 extractions were performed on male subjects and 52 (32.5%) were performed on female subjects. Median age was 22.46 years. The amount of facial swelling varied depending on gender and operating time. Trismus varied depending on gender, operating time and tooth sectioning. The influence of age, gender and operating time varied depending on the pain evaluation period (p < 0.05). Conclusions: Short-term outcomes of third molar operations (swelling, trismus and pain) differ depending on the patients’ characteristics (age, gender and body mass index). Moreover, surgery characteristics such as operating time and tooth sectioning were also associated with postoperative variables. Key words:Third molar extraction, pain, swelling, trismus, postoperative findings, prediction.

Influence of helmet use in facial trauma and moderate traumatic brain injury victims of motorcycle accidents

Objective The objective of this research was to study the influence of the use of helmet in facial trauma victims of motorcycle accidents with moderate traumatic brain injury. Methods We retrospectively reviewed the incidence of facial injuries in helmeted and nonhelmeted victims with moderate traumatic brain injury at a referral trauma hospital. Results The sample consisted of 272 patients predominantly men (94.5%) and between 21 and 40 years old (62.9%). The majority of patients were using helmet (80.1%). The occurrence of facial fractures was most frequent for zygomatic bone (51.8%), followed by mandible (18.8%) and nasal bones (9.2%). Conclusions Individuals in the most productive age group are most affected, which causes a great loss to financial and labor systems. It is important to take measures to alert the public regarding the severity of injuries likely to occur in motorcycle-related accidents and ways to prevent them.

Expression of midkine in ameloblastomas and its correlation with clinicopathologic parameters

OBJECTIVE Midkine (MK) is a heparin-binding growth factor that is overexpressed in various human cancers. The aim of this study was to investigate the expression of MK in ameloblastomas and correlate the results with clinicopathologic parameters. STUDY DESIGN Cases of ameloblastoma seen between 1999 and 2010 were identified. Clinical information was collected regarding age, gender, race, and location of tumor. Cases were classified as solid/multicystic, unicystic, and peripheral. The expression of midkine was assessed using immunohistochemistry. A significant difference was considered present at P < 0.05. RESULTS A total of 34 cases of ameloblastoma and 4 cases of ameloblastic carcinomas were identified. MK was expressed in 67% of lesions (23.5% weak expression; 14.7% moderate expression; 29.4% strong expression). A significant difference was seen between solid/multicystic and unicystic lesions. CONCLUSIONS MK is expressed in the majority of ameloblastomas, suggesting a role of the protein in the tumors development, progression, and behavior.

Iatrogenic infection in dermoid cysts of the floor of the mouth

Doctoral degree in oral pathology, Rio Grande do Norte Federal University (UFRN). Adjunct professor of oral pathology, Pernambuco Dentistry School (FOP), UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco - FOP).Pernambuco University (Universidade de Pernambuco - UPE).Send correspondence to: Thiago de Santana Santos - Faculdade de Odontologia, Universidade de Pernambuco - Av. General Newton Cavalcanti, 1650. CEP: 54753-220. Camaragibe, PE, Brazil. Phone: (+55 81) 345828 - Fax: (+55 81) 34582867 - E-mail: thiago.ctbmf@yahoo.com.brPaper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 4, 2010; and accepted on July 20, 2010. cod. 7063

Adenoid cystic carcinoma of mandible

Specialist in oral and maxillofacial surgery and trauma, head of the residence program in oral and maxillofacial surgery and trauma, Oswaldo Cruz University Hospital - HUOC/UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco or FOP), University of Pernambuco (UPE).Send correspondence to: Faculdade de Odontologia de Pernambuco - FOP/UPE - Av. General Newton Cavalcanti, 1650, Camaragibe - PE. CEP: 54753-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on July 13, 2010; and accepted on September 18, 2010. cod. 7201

An Aggresive Presentation of Pyogenic Granuloma: Pharmacologic and Surgical Case Report

AN AGGRESIVE PRESENTATION OF PYOGENIC GRANULOMA: PHARMACOLOGIC AND SURGICAL CASE REPORT. ISABELA VICÊNCIA MENEZES CASTELO BRANCO, LUIS FELIPE OLIVEIRA MACIEL, MARIANA BARROS ROCHA, ALLANCARDI DOS SANTOS SIQUEIRA, ADRIANA LINS MORAIS, EMANUEL DIAS DE OLIVEIRA E SILVA, ANA CLÁUDIA AMORIM GOMES. A pyogenic granuloma (PG) is a proliferative lesion of nonneoplastic nature, relatively common in the oral cavity, usually located in the gingiva. The differential diagnosis includes lesions, such as peripheral ossifying fibroma, peripheral giant cell granuloma, Kaposi sarcoma, and metastases of malignant tumors. A 12year-old boy, referred by the oncology department, had a lesion in the posterior region of the mandible, with a reddish color, ulcerative surface, spontaneous bleeding, and painful symptoms for about 6 months. A radiographic examination, arteriography of the face, and histopathological examination were performed to obtain the diagnosis. A diagnosis of PG was obtained. The treatment of the lesion involved sclerosis with bleomycin sulfate, embolization, and subsequent surgical treatment. The patient is currently without recurrence of the lesion for 3 years. PG in children may be more aggressive and fast-growing, causing bone resorption, and interfering with tooth eruption.

Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia: a randomized clinical trial

Background To compare the analgesic effect of anesthetic infiltration of lidocaine 2% and low-level laser therapy (LLLT) by GaAlAs into tender points of patients with orofacial pain and fibromyalgia (FM). Material and Methods A randomized clinical trial was performed with adults (N=66) that were allocated into two groups (1:1): Group A received LLLT irradiation by Diode Laser GaAlAs (780nm) with expositions twice a week during six weeks and Group B was treated with anesthetic infiltration of lidocaine 2% without vasoconstrictor once a week for four weeks. The pain assessment included the Visual Analogic Scale (VAS) and tenderness to palpation. Results No dropout and adverse effect was observed during the study. The pain decreased significantly in each group after the treatment (p=0.0001, β=1.0), even though no statistical difference was found between both treatments (p=0.46, β= 0.82). The presence of tender points decreased after both treatments, with responsively in some types of masticatory muscles (p<0.05) except posterior temporalis muscle. The patients’ perception showed that both treatments were effective and a few patients reported that the treatment did not improve welfare. Conclusions The LLLT by GaAlAs and anesthetic infiltration of lidocaine 2% were equally effective to control orofacial pain in FM individuals. Key words:Facial pain, myalgia, rheumatic disease, local anesthesia, phototherapy.

RECIDIVA DE AMELOBLASTOMA PARA TECIDOS MOLES APÓS TRATAMENTO RADICAL

Introduction: Ameloblastomas are locally aggressive jaw tumors with a high propensity for recurrence and believed to originate from remnants of dental lamina or odontogenic epithelium. Radical surgery still remains the first-choice therapy. Case Report: Herein we report the case of a 69-year-old patient admitted to the University Hospital Oswaldo Cruz in Pernambuco, Brazil, exactly eight years after undergoing hemi-mandibulectomy for treatment of a multicystic ameloblastoma. The patient complained of painful, well-delimited swelling measuring about 4 cm in submucosa next to a titanium bone plate that was used for reconstruction. Computed tomographic imaging and incisional biopsy were performed. The lesion was diagnosed as a ameloblastoma. The tumor was resected and histopathological analyses showed predominance of follicular and acanthomatous ameloblastoma within a highly fibrotic area, thus completing the diagnosis of soft-tissue recurrence. Considerations: This report shows the need of monitoring ameloblastomas for a long-term period even after radical treatment. DESCRIPTORS Neoplasm Recurrence Local. Ameloblastoma. Maxillofacial surgery.

Case ReportIatrogenic infection in dermoid cysts of the floor of the mouth

Doctoral degree in oral pathology, Rio Grande do Norte Federal University (UFRN). Adjunct professor of oral pathology, Pernambuco Dentistry School (FOP), UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco - FOP).Pernambuco University (Universidade de Pernambuco - UPE).Send correspondence to: Thiago de Santana Santos - Faculdade de Odontologia, Universidade de Pernambuco - Av. General Newton Cavalcanti, 1650. CEP: 54753-220. Camaragibe, PE, Brazil. Phone: (+55 81) 345828 - Fax: (+55 81) 34582867 - E-mail: thiago.ctbmf@yahoo.com.brPaper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 4, 2010; and accepted on July 20, 2010. cod. 7063