Ana Cristina Rodrigues Antunes de Souza

The importance of intraoral examination in the differential diagnosis of paracoccidioidomycosis

Male, 24 years old, African-Brazilian, came to us complaining of a dental abscess. During the interview he reported a pro-gressive weight loss in the past three years, cough, and he said he tested negative for neck lymph node tuberculosis. According to the patient, having the negative result of the lymph node biopsy, no other tests were carried out in order to find the cause of the symptoms, nor was any type of tre-atment installed. During the physical exam we observed macrocheilia and a moriform ulcerated lesion (Figs. 1A and 1B). After an incisional biopsy (Fig. 1C), the histopatho-logy exam showed the presence of a granu-lomatous chronic inflammation, multinucle-ated gigantic cells and the Paracoccidioides brasiliensis fungus (Fig. 1F). The patient was then referred to the pneumologist, however the refused treatment.

Osteomielitis crónica supurativa en el maxilar superior: reporte de un caso clínico

espanolLa Osteomielitis es una infeccion del tejido oseo que involucra a todas las estructuras del hueso provocada por microorganismos. El cuadro clinico se caracteriza generalmente por la presencia de fistula de drenaje, dolor intenso, inflamacion, movilidad de los dientes involucrados en la zona afectada, fiebre y edema. El tratamiento consiste en medicamentoso y/o quirurgico. En este articulo se presenta un caso de Osteomielitis cronica supurativa en el maxilar superior, que acomete a un paciente del sexo femenino de 82 anos, en el cual se discuten los aspectos diagnosticos e histopatologicos como el tratamiento correspondiente del caso. EnglishOsteomyelitis is an infection of bone tissue that involves all structures of the bone caused by microorganisms. The clinical picture is generally characterized by the presence of fistula drainage, severe pain, swelling, mobility of teeth involved in the affected area, fever and edema. Treatment involves medication and / or surgery. This article presents a case of chronic suppurative osteomyelitis in the maxilar superior of a female 82 years old patient, as well as a discussion of clinical and histopathological aspects and the treatment employed.

Extending Coronectomy Indications to Third Molars with Taurodontism to Prevent Paresthesia and Mandible Fracture

Taurodontism is considered a dental anomaly responsible for a morphoanatomical change in the shape of the tooth in which the roots are reduced in size but the body of the tooth is enlarged and bulky. The aim of this paper is to present a case of a 25-year-old female patient with taurodontism of mandibular partially erupted third molars, presenting a high risk of angle fracture and paresthesia in case of their removal, treated by means of coronectomy. The postoperative period was uneventful and the patient remained in follow-up for 12 months. In conclusion, the identification of third molars with higher risk of complications related to their extractions is the key to consider conservative measures to avoid problems. Coronectomy is a relatively simple technique that should be taken into account when considering bulky, deeply located third molars with a high risk of paresthesia or mandibular fracture, even in presence of taurodontism.

Dientes neonatales: Reporte de un caso y revisión de la literatura

Los dientes natales y neonatales son anomalias relativamente raras en los recien nacidos, que pueden causar trastornos en la alimentacion, ulceraciones traumaticas sublinguales (enfermedad de Riga-Fede) y preocupaciones en cuanto a la aspiracion de los mismos. La diferencia entre los dientes natales y neonatales esta en el momento de la erupcion. Los dientes natales son dientes que aparecen en la cavidad oral en el momento del nacimiento y los dientes neonatales son los que aparecen durante las primeras semanas de vida. El objetivo de este articulo es presentar a traves de una revision de la literatura, los aspectos mas relevantes de los dientes neonatales y la presentacion de un caso clinico de un recien nacido con pocos dias de vida con diente neonatal, donde el tratamiento aplicado fue la extraccion.

Osteonecrose dos Maxilares Associada ao Uso de Bisfosfonatos: Revisão da Literatura e Apresentação de um Caso Clínico.

Resumo Os bisfosfonatos sao medicamentos amplamente administrados a pacientes portadores de câncer de mama e prostata com metastases osseas, mieloma multiplo, osteoporose, doenca de Paget, hipercalcemia maligna e outras lesoes osseas metastaticas. A droga diminui a reabsorcao ossea, inibindo a actividade osteoclastica e o recrutamento de osteoclastos, promovendo a apoptose destes. A osteonecrose dos maxilares associada ao uso de bisfosfonatos tem sido relatada principalmente em pacientes submetidos a intervencoes odontologicas invasivas, como exodontias, cirurgias a retalho, endodontias, dentre outras. O presente estudo teve como objectivo realizar uma revisao de literatura sobre o assunto, levando em consideracao os factores etiologicos, os mecanismos de accao destes medicamentos, seus efeitos adversos e possiveis tratamentos, alem de descrever um caso clinico. Tendo em vista a dificuldade do tratamento e ao risco de intervencoes cirurgicas, pacientes que necessitam de medicamentos da classe dos bisfosfonatos devem, se possivel, ser submetidos a um exame odontologico criterioso, no qual todos os procedimentos necessarios sejam realizados previamente ao seu uso, diminuindo-se assim, os riscos da ocorrencia de osteonecrose.