Andrea Lusvarghi Witzel

Analysis of nonspecific oral mucosal and dermal lesions suggestive of syphilis: a report of 6 cases.

Analysis of nonspecific oral mucosal and dermal lesions suggestive of syphilis: a report of 6 cases Natalie Kelner, DDS, MSc, Gustavo Davi Rabelo, DDS, MSc, Danyel Elias da Cruz Perez, DDS, PhD, Jose Narciso Rosa Assuncao, Jr., DDS, MSc, Andrea Lusvarghi Witzel, DDS, PhD, Dante Antonio Migliari, DDS, PhD, and Fabio Abreu Alves, DDS, PhD A. C. Camargo Hospital and University of Sao Paulo, Sao Paulo, Brazil (Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117:1-7)

Oral candidiasis in HIV+ patients under treatment with protease inhibitors

The purpose of this work was to evaluate the influence of Protease Inhibitors (PI) on the occurrence of oral candidiasis in 111 HIV+ patients under PI therapy (Group A). The controls consisted of 56 patients that were not using PI drugs (Group B) and 26 patients that were not using any drugs for HIV therapy (Group C). The patients cd4 cell counts were taken in account for the correlations. One hundred and ninety three patients were evaluated. The PI did not affect the prevalence of oral candidiasis (p = 0.158) or the frequency of C. albicans isolates (p = 0.133). Patients with lower cd4 cell counts showed a higher frequency of C. albicans isolates (p = 0.046) and a greater occurrence of oral candidiasis (p = 0.036).

A Rare Case of Concomitant Maxilla and Mandible Brown Tumours, Papillary Thyroid Carcinoma, Parathyroid Adenoma, and Osteitis Fibrosa Cystica

Objective. The brown tumour of hyperparathyroidism is a result of a metabolic disorder caused by primary hyperparathyroidism. Report. We described a case of a 37-year-old female patient presenting bimaxillary intraoral lesions and swelling in the neck. Incisional biopsy of the oral lesion was performed and histopathological examination revealed a central giant cell lesion composed by intense haemorrhagic exudate, abundant presence of giant cells, and areas with hemosiderin pigment. The patient also presented high levels of serum calcium and parathyroid hormone, hyperfunctioning parathyroid tissue, bilateral parenchymal nephropathy, and densitometry lower than expected, showing an advanced stage of osteitis fibrosa cystica. Synchronous parathyroid adenoma and papillary thyroid carcinoma were confirmed by imaging exams and histopathologically. Conclusion. The composition of all the clinical, pathological, and imaging findings led to the final diagnosis of brown tumour of hyperparathyroidism. The occurrence of parathyroid adenoma, papillary thyroid carcinoma, and brown tumours of hyperparathyroidism in their late stage (osteitis fibrosa cystica) associated with oral brown tumours involving the mandible and maxilla is extremely rare.

A novel vibratory stimulation-based splint for chronic and untreatable masticatory myofascial pain: A case-series

AIM This clinical report aimed to introduce a novel vibratory stimulation-based occlusal splint (VibS) for management of chronic and untreatable masticatory myofascial pain (MMFP). METHODS This study was conducted on four chronic MMFP patients (mean age: 27.5±5.56 years, females) who were diagnosed according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD), and who were using stabilization splints for more than 6 months and still complained of pain above 40 mm in a 100-mm VAS scale. The included subjects utilized the active VibS and subsequently the inactive VibS during 30 days in each trial, separated by a wash-out period of at least 8 months. VAS pain levels were the only measured dependent variable, and were recorded before and after the use of active VibS and inactive VibS. RESULTS At baseline, mean VAS pain levels before using the active or inactive splint were 54.5±19.8 mm and 44.0±13.6 mm, respectively. After using the active VibS, mean pain level decreased by 77% (VASpos-pre=-42.0±30.3 mm). On the other hand, after using the inactive VibS, severe pain aggravation of 67% in magnitude was observed (VASpos-pre=+29.5±21.5 mm). CONCLUSION This case-series study demonstrated a good tendency of this novel VibS in chronic MMFP alleviation after a 4-week management period compared to a control inactive VibS.

Caliber-Persistent Artery

Caliber-persistent artery (CPLA) of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints.

Vibratory splint therapy for decreasing sleep clenching: A pilot study

Abstract Objective To estimate the effect of a vibratory splint (VibS) in reducing sleep clenching (SC) and TMD pain. Methods Target sample was consecutive 19 TMD patients attending the Orofacial Pain Clinic at FFO-FOUSP. Patients used the VibS or acrylic occlusal splint (OS) as control for 14 days. Outcome variables were SC frequency and pain, assessed by a portable electromyography detector-analyzer (BiteStrip™) and 100 mm VAS, respectively. Statistical analyses were performed with two-way repeated measures ANOVA, and analysis of covariance (ANCOVA). Results VibS promoted a marked decrease, whereas acrylic OS increased SC frequency after two weeks of use. Due to a significant difference in initial VAS levels between VibS and control group, the effect of the two splints on TMD pain could not be clearly estimated. Conclusion The results suggested that VibS can potentially be used to reduce SC frequency, although further studies with larger sample size are necessary to confirm these findings.

The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study

This study assesses the efficacy of photobiomodulation therapy (830 nm) for myalgia treatment of masticatory muscles. Sixty patients with muscular myalgia were selected and randomly allocated into 2 groups (n=30): Group A comprised patients given a placebo (control), and Group B consisted of those undergoing photobiomodulation therapy (PBMT). PBMT and placebo were applied bilaterally to specific points on the masseter and temporal muscles. Referred pain elicited by palpation and maximum mouth opening were measured before (EV1) and after (EV2) the treatments. The data were analyzed using statistical tests, considering a significance level of 5%. No significant differences in range were observed for active or passive mouth opening (p ≥ 0.05). Comparing the final outcomes (EV1-EV2) of both treatments, statistical significance was verified for total pain in the right masseter muscle (p = 0.001) and total pain (p = 0.005). In EV2, significant differences in pain reported with palpation were found between Groups A and B for the following: left posterior temporal muscle (p = 0.025), left superior masseter muscle (p = 0.036), inferior masseter muscle (p = 0.021), total pain (left side) (p = 0.009), total masseter muscle (left side) (p = 0.014), total temporal (left side) (p = 0.024), and total pain (p = 0.035). We concluded that PBMT (830 nm) reduces pain in algic points, but does not influence the extent of mouth opening in patients with myalgia.