Ana Claudia Luiz

LASER PHOTOTHERAPY AS TOPICAL PROPHYLAXIS AGAINST HEAD AND NECK CANCER RADIOTHERAPY-INDUCED ORAL MUCOSITIS: COMPARISON BETWEEN LOW AND HIGH/LOW POWER LASERS

Oral mucositis is a dose‐limiting and painful side effect of radiotherapy (RT) and/or chemotherapy in cancer patients. The purpose of the present study was to analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and degree of pain in patients under RT.

Treatment of painful and recurrent oral mucoceles with a high-potency topical corticosteroid: a case report.

Single mucoceles are a relatively common disorder of the oral mucosa, but the occurrence of multiple mucoceles is considered an uncommon event. There are only a few reports in the literature. 1-6 Although no etiologic factor has been associated with multiple mucoceles, some authors reported on this condition in patients with oral lichen planus and in association with graft-versus-host disease. 1,6,7 There is a hypothesis that an inflammatory process may play a role in the pathogenesis of recurrent mucoceles, 6,7 although it was also argued that changes in minor salivary-gland function may contribute to the development of these lesions. 2

Drug‐induced pigmentation of hard palate and skin due to chronic chloroquine therapy: report of two cases

Pigmentation of the oral mucosa is usually associated with physiological melanin deposition and is usually seen in dark-skinned people. In white patients, oral pigmentation calls for careful examination. Isolated and wellcircumscribed pigmented lesions are usually diagnosed as melanocytic naevus, melanotic macule or amalgam tattoo, or more uncommonly as an initial sign of melanoma, whereas diffuse or multifocal pigmented lesions are more likely to be a sign of underlying systemic disorder, such as Addison s disease, Peutz–Jeghers syndrome, melanoplakia or human immunodeficiency virus (HIV) infection, or a side-effect of drug therapy. The drugs more commonly implicated in hyperpigmentation of the skin and oral mucosa tissues are the antimalarials, tetracycline, zidovudine, and nonsteroidal anti-inflammatory drugs. We report two patients who presented with oral pigmentation. Patient 1 was a 65-year-old white woman who presented with a 90-day history of a diffuse blue-grey pigmentation on the hard-palate mucosa (Fig. 1a). On examination, she was also found to have blue-grey

Use of laser phototherapy on a delayed wound healing of oral mucosa previously submitted to radiotherapy: case report

Radiotherapy produces both acute and delayed effects on mucosal tissues, disturbing their healing. This report shows a successful treatment with laser phototherapy (LPT) on a delayed wound healing in oral mucosa previously submitted to radiotherapy with a follow up of 3 years. A 47‐year‐old patient treated 6 months earlier for tongue squamous cell carcinoma by surgery and radiotherapy presented with a mass in the operated area. Biopsy showed chronic inflammatory infiltrate around a residual polyglactin suture. After 2 months there was a painful mucosal dehiscence on the biopsy site. LPT was performed using a semiconductor laser with 660‐nm wavelength (InGaAlP) and spot size of 0·04 cm2. The parameters applied were 40 mW, 4 Jcm2/point, 0·16 J/point, 2·4 J/session. The irradiation was performed punctually, through contact mode in 15 points (4 seconds/point), on top of and around the lesion, during ten sessions. The wound healed completely after ten sessions. This treatment proved to be conservative and effective, inducing healing of a chronic wound in a tissue previously submitted to radiotherapy.

Alterações bucais e cuidados orais no paciente transplantado de medula óssea

General care in bone marrow transplant (BMT) patients includes routine dental evaluations, which must be included in a multi-professional context. The oral cavity is a site that favors infections with high potential for consequent bacteremia and so infectious lesions must be treated or controlled by the dentist. The aim of this review is to discuss key questions in national and international literature with reference to oral inflammatory conditions of BMT patients, both those with predisposition to complications during the transplant and those that emerge during and after myelosuppression therapy. The literature emphasizes advanced periodontal disease, which is a chronic infectious condition that must be avoided or controlled during BMT, particularly because of the presence of S. viridans. The risk factors for oral mucositis, graft-versus-host disease (GVHD) and xerostomia have not yet been defined, particularly for oral mucositis and GVHD. Promising alternatives in the treatment of oral mucositis, including cryotherapy, administration of growth factors and laser therapy, are emphatically mentioned. In children, craniofacial and dental alterations, particularly resulting from radiotherapy are relevant. The increased risk of caries is controversial, and among fungal and viral lesions, oral and oropharyngeal infections by Candida and the herpes virus are identified as being of considerable clinical importance.