Cláudio Maranhão Pereira

Dental Alterations Associated with X-Linked Hypophosphatemic Rickets

The X-linked hypophosphatemic rickets is a rare metabolic disorder characterized by low serum phosphate levels caused by a decreased renal tubular reabsorption of inorganic phosphates. The initial complaints are a delay in the development of walking caused by deformity of the legs. Oral findings include poorly mineralized dentin, enlarged pulp chambers and root canals, and periradicular abscesses in caries-free teeth. We present three patients from the same family with X-linked hypophosphatemic rickets showing bone and dental alterations.

Candida in saliva of Brazilian hemophilic patients

Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.

Paracoccidioidomycosis in pregnancy: an atypical case report

A 38-year-old woman was referred to the department of OralPathology at the Universidade Paulista, Goiânia, Brazil, com-plaining of multiple painful ulcers on the gum and upper lipmucosa. The patient was six month pregnant and had reg-ularly attended prenatal visits. The patient had a history ofweight loss due to inability to swallow solid foods in the lasttwo months. Also, the patient complained of drooling. Herpulse and blood pressure were normal.Clinicalexaminationrevealedpalpablelymphnodesinthesubmandibular region. The facial muscles were normal andshowed no visible asymmetry. The intra oral examinationshowed the presence of multiple painful moriform ulcers inthe upper gum, palate and upper lip. The lesion on her lip wassimilar to a granulomatous cheilitis (Fig. 1). The gum lesionswere mulberry-like, with distinctly visible hemorrhagic pin-points on the surface (Fig. 2). The teeth involved had severedegrees of mobility, such as in periodontal disease.Incisional biopsy was performed in the gum, where thehistological sections revealed the presence of granulomatousinflammation, with pseudoepitheliomatous hyperplasia, withthe presence of macrophages, epithelioid cells, multinucle-ated giant cells, histiocytes, as well as lymphocytes (Fig. 3).