Gilberto Marcucci

Prevalência das maloclusões e dos índices anamnésicos e clínicos, em pacientes com disfunção da articulação temporomandibular

The authors analyzed the frequency of malocclusion, Helkimo (1974) anamnestic and clinical dysfunction indexes in patients with temporomandibular joint dysfunction and their possible correlation. One hundred and ten patients with these conditions were evaluated independent of age and gender. Signs and symptoms were evaluated, indicating levels of Helkimo indexes, Angle classification, over-jet, over-bite, cross-bite and missing teeth. The authors concluded that there was a high incidence of Angle class II and overjet larger than two milimeters. Among the Helkimo indexes there was a slight predominance of Anamnesthic Index AiII (symptoms of severe dysfunction) and Clinical Index level DiI (mild dysfunction). A statistically significant relationship was found between the Clinical Index and the Angle classification as between Anamnestic Index and overbite.

Lichen sclerosus et atrophicus.

A case of lichen sclerosus et atrophicus (LSA) involving the oral mucosa is described. The lesion began in the labial mucosa with extension to the gingiva and to the skin. The frequency of occurrence of oral lesions of LSA is discussed, and a histopathologic comparison with skin lesions is made.

Pesquisa de Mycobacterium leprae em biópsias de mucosa oral por meio da reação em cadeia da polimerase

BACKGROUND - Hansens disease is endemic in South America, which accounts for 3% of total world cases, and particularly in Brazil, which accounts for 85% of all South American cases. The bacteria can be found in the oral mucosa with no evident signs of infection, and only very sensitive laboratory assays can detect its presence. OBJECTIVES - The aim of this study was to ascertain if the M. leprae genome can be detected by PCR in small punch biopsy specimens from the oral mucosa of patients with Hansens disease. METHODS - The normal oral mucosas of seven multibacillary Hansens disease patients were biopsied. Five of them were under treatment at the time of the study. Diagnosis of Hansens disease could be determined by conventional hematoxylineosin and Fite-Faraco staining for M. leprae in only one patient. This patient had not received treatment prior to the time of the biopsy. The paraffin embedded specimens were submitted to PCR for M. leprae. RESULTS - Six out of seven cases showed positivity for M. leprae, and the remaining case showed positivity for Mycobacterium sp., demonstrating the high sensitivity and specificity of this method. CONCLUSIONS - PCR is a fast, easy and reliable method for routine investigation of mycobacterial infection, even during nonsymptomatic periods. Diagnosis can be achieved through a simple oral biopsy at an outpatient clinic.

Processos proliferativos gengivais não neoplásicos em paciente sob tratamento ortodôntico

INTRODUCTION: Orthodontic appliances render oral hygiene difficult and may contribute to the development of gingival lesions such as non-neoplastic proliferative gingival processes. These lesions, depending on such factors as development time, histopathological components and oral conditions may be reversible in some cases - through oral hygiene advice and basic periodontal therapy. In most cases, however, surgical treatment is required. OBJECTIVES: The purpose of this paper is to report the case of a patient using fixed orthodontic appliance who presented with two distinct gingival lesions diagnosed as pyogenic granuloma and inflammatory gingival hyperplasia. The clinical and histopathological features, incidence and frequency, treatment modalities and prevention of both lesions were discussed, highlighting the importance of submitting the material collected from the lesions to histopathological examination given the possibility of different diagnostic hypotheses. Surgical excision was performed on both lesions. The upper arch lesion, diagnosed as pyogenic granuloma, relapsed, which led us to provide basic periodontal therapy and repeat the surgical procedures. RESULTS: The lesion in the lower arch, diagnosed as gingival hyperplasia, was surgically removed and followed up clinically, whereas the patient was instructed to perform proper oral hygiene

Mantle cell lymphoma: involvement of nodal and extranodal sites in the head and neck, with multifocal oral lesions

Mantle cell lymphoma (MCL) is a malignant B-cell neoplasm, which comprises monomorphic and small- to medium-sized mantle zone-derived lymphoid cells. It is characterized by chromosomal translocation t(11;14)(q13;q32) and CCND1 truncation, resulting in cell cycle deregulation. It is an aggressive type of non-Hodgkin lymphoma with a propensity to present with extranodal involvement. This study shows the case of an 80-year-old Caucasian male who complained of a 2-month progressive swelling on the right side of his face. The magnetic resonance imaging exam showed multifocal involvement of the head and neck, including oral manifestations, bilateral parotid glands, palate, tongue, and floor of the mouth. An incisional biopsy of the tumor mass was performed. The morphological and immunophenotypic findings were consistent with the diagnosis of MCL. The patient died 4 months later, without any chance of undergoing a therapeutic approach. Although MCL is a rare condition, it should be subjected to a differential diagnosis when affecting the maxillofacial area. Imaging exams and both immunohistochemical and morphological analyses are needed to reach the correct diagnosis. Here, we present an unusual MCL with multifocal involvement of the head and neck.