Fabrício Mesquita Tuji

Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections

Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Recently, bisphosphonates have been used to treat central giant cell lesions. A case of a 36-year-old male with a central giant cell lesion crossing the mandibular midline was treated with intralesional corticosteroids combined with alendronate sodium for the control of systemic bone resorption. The steroid injections and the use of bisphosphonates were stopped after seven months when further needle penetration into the lesion was not possible due to new bone formation. After two years, the bony architecture was near normal, and only minimal radiolucency was present around the root apices of the involved teeth. The patient was followed up for four years, and panoramic radiography showed areas of new bone formation. Thus far, neither recurrence nor side effects of the medication have been detected.

Dentomaxillofacial manifestations of mucopolysaccharidosis VI: clinical and imaging findings from two cases, with an emphasis on the temporomandibular joint

OBJECTIVESnUsing a clinical survey, panoramic, cone-beam computed tomography (CBCT), and magnetic resonance (MR) imaging, this study was conducted to ascertain primary maxillofacial abnormalities in patients with mucopolysaccharidosis VI (MPS VI).nnnSTUDY DESIGNnTwo patients previously diagnosed with MPS VI underwent clinical and imaging surveys (panoramic radiographs, CBCT, and MR imaging).nnnRESULTSnJaw involvement was present in all patients. The most prevalent findings were enlarged marrow spaces, osteopenia, dentigerous cyst-like follicles, effacement of the jaw structures, and osteosclerosis. This is the first study to describe temporomandibular joint (TMJ) involvement for MPS VI.nnnCONCLUSIONSnCBCT and MR imaging were needed to observe features that were not clear in conventional radiographs. Both patients reported symptoms in the TMJ and demonstrated involvement during their examinations. A multicenter study is necessary to better document maxillofacial involvement in MPS VI.

Prevalence of calcified carotid artery atheromas in panoramic radiographs of HIV-positive patients undergoing antiretroviral treatment: a retrospective study

OBJECTIVEnThis study investigated the prevalence of calcified carotid artery atheromas (CCAAs) in panoramic radiographs of HIV-positive patients.nnnSTUDY DESIGNnA retrospective cross-sectional study was performed to evaluate the presence of CCAA in 300 panoramic radiographs. Qualitative variables were compared using the χ(2) test or Fisher exact test, as needed. The Mann-Whitney or Student t test was used for the quantitative variables.nnnRESULTSnIn the studied group, 8.2% presented CCAA. Among these patients, most used lopinavir/ritonavir (P = .0459), had a greater mean age (P = .0081), and displayed a lower nadir CD4 (P = .0195). The use of lopinavir/ritonavir increased the chances of CCAA by approximately 2.8-fold compared with those who did not use medication (odds ratio, 2.79; 95% confidence interval, 1.12-6.95; P = .045).nnnCONCLUSIONSnThe variables that were associated with the identification of CCAA are compatible with the known atherogenic risk factors in patients with HIV.

Melanotic neuroectodermal tumor of infancy in an African-indigenous patient from the Amazon: a case report

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare condition that occurs normally in the anterior maxilla of infants aged <1xa0year. The use of clinical and imaging tools for MNTI is extremely important to prevent problems with function as well as the aesthetic features in a breastfeeding child. Brazil is a multiethnic country with a poor epidemiological policy and little data to track the incidence of certain diseases, including MNTI. It is important to study this pathology with ethnicity as a factor to improve the current epidemiological programs and establish better post-treatment management. This paper describes a case of a 2-month-old male of African-indigenous descent and Brazilian Amazon residency, who presented to our unit in 2009 with a history of an expanding mass involving the anterior maxilla. Clinical and computerized tomography scans were used to diagnose the mass as MNTI, which was removed by total excision. A biopsy later confirmed the MNTI diagnosis.

Therapeutic effect of andiroba oil (Carapa guianensis Aubl.) against oral mucositis: an experimental study in golden Syrian hamsters

ObjectivesThe aim of this study was to investigate the healing activity of andiroba (Carapa guianensis Aubl.) against oral mucositis (OM) induced by 5-fluorouracil in golden Syrian hamsters.Materials and methodsA total of 122 animals were randomized and divided into six groups: andiroba oil 100%, andiroba oil 10%, andiroba oil 10% refined, no treatment group, all nu2009=u200928; and negative control (NC) and cyclophosphamide (CPA) groups, both nu2009=u20095. OM was induced by intraperitoneal administration of 60xa0mg/kg 5-FU on days 0, 5 and 10 followed by mechanical trauma on the oral mucosa on days 1 and 2. From day 1 to day 15, the animals of the andiroba group were treated three times a day. On days 4, 8, 12 and 15, the mucosa was photographed and removed for clinical and histopathological analysis. The bone marrow of the femur was removed and the micronucleus test was performed to evaluate the cytotoxicity and genotoxicity. The data were subjected to analysis of variance, followed by the Tukey and Bonferroni test.ResultsTreatment with 100% andiroba oil reduced the degree of OM compared to that reported in the other groups (pu2009<u20090.05). Andiroba oil at both concentrations was not cytotoxic, but treatment with 100% andiroba oil showed a genotoxic potential (pu2009<u20090.001).ConclusionsFrequent administration of andiroba oil accelerated the healing process in an experimental model of 5-fluorouracil-induced OM. However, the genotoxicity of andiroba in other cell systems and under other conditions are being tested.Clinical relevanceThe use of andiroba in topical form may be associated with reduced intensity of OM. Seek therapeutic alternatives to minimize the pain and suffering that these side effects cause cancer patients is an important scientific step.

Clinical and radiographic features of Hutchinson-Gilford progeria syndrome: A case report.

Hutchinson-Gilford progeria syndrome (HGPS) is a rare dysmorphic syndrome characterized by several features of premature aging with clinical involvement of the skin, bones, and cardiovascular system. HGPS has an estimated incidence of one in four million to one in eight million births. The main clinical features of HGPS include short stature, craniofacial dimorphism, alopecia, bone fragility, and cardiovascular disorders. The most frequent cause of death is myocardial infarction at a mean age of 13 years old. Dental manifestations include delayed development and eruption of teeth, discoloration, crowding and rotation of teeth, and displaced teeth. Cone beam computed tomography images revealed the absence of the sphenoid, frontal, and maxillary sinus, flattening of the condyles and glenoid fossa, and bilateral hypoplasia of the mandibular condyles. The disease is caused by mutations in lamin A/C (LMNA). Here, we present a case report of an 11-year-old boy with classical features of HGPS, which was caused by a de novo germ-line mutation (C1824T, G608G) in exon 11 of the LMNA gene. Some uncommon HGPS-associated features in our patient, such as alterations in the facial sinuses and hypoplasia of the condyles, contributed to the expansion of the phenotypic spectrum of this syndrome from a dentomaxillofacial perspective.

Evaluation of mandibular odontogenic keratocyst and ameloblastoma by panoramic radiograph and computed tomography

OBJECTIVES:nThe purpose of this study was to describe and compare the main imagenological features of mandibular ameloblastomas and odontogenic keratocyst (OKC) using panoramic radiograph (PR) and CT.nnnMETHODS:nThe sample consisted of nine cases of ameloblastomas and nine cases of OKC. PR and CT images were analyzed according to shape, internal structure, borders, associated unerupted tooth, root resorption, expansion and perforation of cortical bones.nnnRESULTS:nPR evaluation allowed the identification of the lesions location, presence of sclerosis in the periphery, presence of associated non-erupted tooth and expansion of the mandibles lower border cortical bone. CT was more accurate than PR in the assessment of the lesion shape, presence of inner bone septa, root resorption, buccolingual expansion and rupture of cortical bone. Most cases of ameloblastoma and OKC presented buccolingual expansion and erosion of cortical bone. Only ameloblastomas showed tooth root resorption.nnnCONCLUSIONS:nAlthough PR is very helpful and widely used, CT provides more precise information on buccolingual expansion, calcification, bone septa, perforation of cortical bones and tooth resorption, features that are frequently underdescribed in the literature, particularly in OKC.

Anatomical relation between nasal septum deviation and oropharynx volume in different facial patterns evaluated through cone beam computed tomography

IntroductionThe objective of this study was to establish the anatomical relation between nasal septum deviation (NSD) and oropharynx volume in different facial patterns using cone beam computed tomography (CBCT).MethodsNinety CBCT examinations were analyzed. InVivoDental software was used to evaluate cephalometric image reconstructions in terms of facial type, determined from cephalometric measurements indicative of growth direction; the presence of NSD was also evaluated. ITK-SNAP software was employed for delimitation of the oropharynx. Intra-examiner error methods were recorded. The results were subjected to parametric and non-parametric tests using Bioestat 5.0.ResultsA comparison of facial types revealed a significantly lower prevalence of NSD in the dolichofacial group compared with the brachyfacial and mesofacial groups (Pxa0=xa00.0101 and 0.0149, respectively). In the total sample, there was a very strong positive relation between the presence of NSD and oropharynx space volume (Pxa0=xa00.0162). The oropharynx volume was larger in all facial patterns in the presence of NSD.ConclusionThe presence of NSD was not associated with facial type, although the oropharynx volume in patients with NSD increased. Therefore, deviation of the septum influences oropharynx volume.

Cone-Beam Computed Tomography Findings in the Early Diagnosis of Calcified Atheromas

PURPOSEnComputed tomograms of the mandibles of 285 patients with indications for dental implants were evaluated at a private clinic.nnnMATERIALS AND METHODSnThis study involved the evaluation of 285 cone-beam computed tomograms of patients 50 to 75xa0years of age who were referred to the clinic for the evaluation for implant placement images with visible C3 and C5 vertebrae that were obtained using the same I-Cat tomographic device (Imagingxa0Sciences-Kavo, Hatfield, PA). Atheromas in the carotid space were visualized using paraxial images.nnnRESULTSnData were analyzed using Student t and χ2 tests, with a significance level of a P value less than or equal to .05. Atheromas in the carotid space were observed in 17.89% of patients; a significant difference in the incidence of atheromas was observed between men (24.27%) and women (14.29%; Pxa0= .034). However, no significant correlation was found between the frequency of occurrence of atheromas and the affected side of the carotid bifurcation (right or left) in women (Pxa0= .431) or men (Pxa0= .558).nnnCONCLUSIONnBased on these results, cone-beam computed tomography could be a useful tool for the diagnosis of atheroma.

Formation of ghost images due to metal objects on the surface of the patient's face: A pictorial essay.

Panoramic radiographs are a relatively simple technique that is commonly used in all dental specialties. In panoramic radiographs, in addition to the formation of real images of metal objects, ghost images may also form, and these ghost images can hinder an accurate diagnosis and interfere with the accuracy of radiology reports. Dentists must understand the formation of these images in order to avoid making incorrect radiographic diagnoses. Therefore, the present study sought to present a study of the formation of panoramic radiograph ghost images caused by metal objects in the head and neck region of a dry skull, as well as to report a clinical case n order to warn dentists about ghost images and to raise awareness thereof. An understanding of the principles of the formation of ghost images in panoramic radiographs helps prevent incorrect diagnoses.