Gustavo Zanna Ferreira

Vancomycin-induced thrombocytopenia: a rare adverse effect in a patient -submitted to bone graft in the jaw.

INTRODUCTION Thrombocytopenia is the reduction in the number of blood -platelets, which may be caused by -several different conditions such as sepsis, disseminated intravascular -clotting, and large blood losses. Additionally, in rare situations, thrombocytopenia may also be induced by the use of medicaments. One of these drugs is the vancomycin, a glycopeptide presently used against -serious infections involving Gram-positive bacteria such as the methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus. OBJECTIVE The objective of this study is to report on a case of serious vancomycin-induced thrombocytopenia in a patient infected with methicillin-resistant S. aureus after mandibular reconstruction with autogenous bone graft, and to draw attention to the importance of this clinically rare adverse effect. CONCLUSION Vancomycin-induced thrombocytopenia is a rare condition, which is also a significant disorder that demands attention and the rapid identification and replacement of the antimicrobial agent.

Treatment of extensive cystic lesion in the maxilla associated with dens in dente

Dens in dente is a dental development malformation that involves more commonly the upper lateral incisors. Infection of the canal of these teeth can cause the formation of chronic periapical lesions. The present study aimed to describe an integrated approach between the endodontic therapy and surgical intervention in an upper lateral incisor with dens in dente type II. A female patient, 14 years old, looked for dental care complaining of left palatal and paranasal bulging. Clinical, radiological and histopathological findings suggested periradicular cyst. First, marsupialization was performed to reduce the size of the lesion and to favor its enucleation, with less risk of injuring the tooth and vital structures. After diagnosis of pulp necrosis and in attempt to reduce the infection via canal, we used the reciprocating instrumentation associated with irrigation with sodium hypochlorite, intracanal medication based on calcium hydroxide and filled with a thermoplastic filling. After a year of marsupialization, fistulectomy and complete enucleation of the lesion were performed. Proservation was performed 1, 3, 6 and 12 months following marsupialization. Six months after enucleation, we observed the periradicular repair and remission of symptoms. The extensive apical lesion associated with dens in dente type II can be treated with a combination of surgical and endodontic therapy.

Presença de Dente Neo-Natal em Portador da Síndrome de Ellis Van-Creveld: Relato de Caso

Abstract The aim of this article is go over the literature and describe a case of Ellis Van Creveld syndrome, in which the patient presented a neo-natal tooth Just-born and premature patient, female, came to the hospital of Limeira, Sao Paulo, and was attended by the Surgery and Maxillofacial Traumatology group from the Dentistry College of Piracicaba (FOPUNICAMP). Her main complaint was the neo-natal tooth. During the extraoral examination it was detected a tower shaped cranium, shortened limbs, lank and sparse hair, bilateral postaxial polydactyly, hypoplasic nails and heart changes. In the intraoral examination the signs included multiple labial frenum associated with gingival changes, and presence of a conic neo natal teeth. The diagnosis of Ellis van Creveld syndrome was based on the clinical and radiographic findings that included characteristics from Chondroectodermal dysplasia. It was not found any history of this syndrome in her family. Being thus, the Ellis Van Creveld Syndrome although rare, presents many characteristics that demand a multidiscipline treatment. Odontologic manifestations are there, thats why surgeons, especially dentists, must be aware of it so that their behavior can contribute for the patient well-being.