Israel Leal Cavalcante

Clinical and histopathological features of nasopalatine duct cyst: A 47-year retrospective study and review of current concepts

PURPOSEnTo evaluate the clinical and histopathological features of nasopalatine duct cysts (NDCs) stored in the archives of a referred Oral Pathology Service over a 47-year-period, and to review current concepts about these cysts.nnnMATERIAL AND METHODSnAll NDCs were reviewed, and clinical data were obtained from the patient records. Thirty cases were re-evaluated microscopically by 2 oral pathologists.nnnRESULTSnAmong 14,564 cases, 30 (0.20%) were NDCs. Fifteen (50.0%) of the patients were female, and the mean age was 42.7 years. The lesions measured on average 2.37xa0±xa01.69xa0cm. Histologically, stratified squamous epithelium, alone or in combination with other epithelia, was present in 13 (46.6%) cases. Goblet cells and subepithelial hyalinization were common. Fourteen (46.6%) cases exhibited a slight degree of inflammation. Nerves were observed in 15 (50%) cases and mucous glands in 7 (23.3%). Hyaline ring granulomas (which is described here for the first time in NDC) and cholesterol crystals were not common.nnnCONCLUSIONnKnowledge of clinical-histopathological aspects of NDCs provides more accurate data about their nature and behavior. Our results suggest that the predominant epithelial lining of these cystic lesions is exclusively stratified squamous epithelium or combined with another type. Vessels, nerves, mucous glands and inflammatory infiltrate are frequently observed.

Eagle's Sydrome: Diagnosis and Incidence in a Brazilian Population

288 Objetivo: estabelecer a incidência da síndrome de Eagle (SE) no curso de Odontologia da Universidade de Fortaleza durante o período de três anos. Materiais e métodos: foram analisadas 945 radiografias panorâmicas. A avaliação foi realizada por dois examinadores em ambiente sem iluminação e com a utilização de negatoscópio. Um paquímetro digital foi utilizado para a mensuração dos casos com alongamento do processo estiloide, sendo considerados alongados os casos a partir de 30 mm. Resultados: das 945 radiografias analisadas, notou-se crescimento do processo estiloide superior a 30 mm em 75 panorâmicas (7,9%), sendo 51 (68%) mulheres e 24 (32%) de homens. Em 43 casos (57,3%), o alongamento foi encontrado bilateralmente, em 23 casos (30,7%) foi encontrado apenas no lado esquerdo e em 9 casos (12%) apenas no lado direito. Os 75 pacientes que possuíam o alongamento do osso foram submetidos a um questionário semiestruturado e 11 pacientes relataram sintomatologia dolorosa, com frequência variável de surgimento da dor. Uma detalhada anamnese e um exame físico desses pacientes permitiram o diagnóstico da SE em quatro deles. Conclusão: o trauma na região craniofacial foi o fator etiológico mais evidente nos pacientes diagnosticados com a SE. Os sinais e sintomas inerentes à SE eram semelhantes aos observados nas desordens craniomandibulares, podendo ocasionar falsos diagnósticos e tratamentos equivocados.

Quantification of bone gain in central giant cell granuloma of the jaws submitted to intralesional corticotherapy

Introduction: The central giant cell granuloma (CGCG) is a bone alteration of unknown etiology that can affect the jaws and presents varied clinical behavior. Objective: To analyze radiographs from patients with CGCG submitted to intralesional corticosteroids, in order to quantify bone gain after treatment. Methods: Sixteen patients with the microscopic diagnosis of CGCG were selected from the Batista Memorial Hospital, in Fortaleza, Ceará, Brazil. Thirty-two radiographs (16 initial and 16 final) were evaluated by the mean pixel values of the affected region before and after the complete corticosteroid intralesional application protocol (six applications in biweekly intervals of triamcinolone hexacetonide). Results: Of the patients submitted to the study, 14 (87.5%) presented a mean increase in the values of pixels, understood as bone gain, in the radiographs after treatment with intralesional injections, and two (12.5%) did not present it. The comparison of the mean pixel values between the initial and final test sides showed p = 0.0027, which was statistically significant, confirming the increase in density in the studied regions. Conclusion: The tools for analysis of pixel values were useful in the quantification of bone gain in patients submitted to intralesional corticosteroid therapy, and these tools should be further explored and used during treatment as auxiliary methods in the evaluation of its efficacy.

Terapia conservadora para lesão central de células gigantes: relato de caso

Case report of central giant cell lesion (CGCL) in a 32-year-old female patient, who exhibited asymptomatic increase in mandible volume and integrity of the adjacent alveolar mucosa, she was submitted to conservative treatment. The imaging exams showed radiolucent and multilocular lesion with displacement and discrete root resorption of the teeth 34 and 35. An incisional biopsy was performed and the final diagnosis of CGCL was established. The patient was submitted to biweekly applications of triamcinolone hexacetonide, showing no recurrence and exhibiting bone reintegration. Treatment of extensive lesions with intralesional corticosteroid injections has shown satisfactory effects.