Riedel Frota

Mandibular osteomyelitis and fracture in a patient with pyknodysostosis.

Pyknodysostosis is a rare, recessive, hereditary, autosomal disease belonging to the group of bone dysplasias. Complications such as osteomyelitis and fractures of the mandible are not uncommon and appear in the most varied forms. We report a case of chronic osteomyelitis with subsequent mandible fracture, which was successfully treated with the use of a reconstruction plate and antibiotic therapy. This article outlines the clinical and radiographic characteristics of this condition based on the clinical case described and proposes an approach regarding the best form of treatment. Considering the risks of fracture subsequent to removal of the graft from long bones as well as the presence of chronic infection, difficult-to-defeat infection, and bone contact on the compression band, the best choice is a more conservative treatment.

Extensive cervical necrotizing fasciitis of odontogenic origin.

Necrotizing fasciitis (NF) is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. The authors report a case of necrotizing fasciitis from odontogenic origin in a patient with uncontrolled diabetes mellitus. The initial diagnosis was based on clinical information, in which multiple necrosis areas in cervical and thoracic regions were observed. Wide antibiotic therapy was applied, followed by surgical drain age and debridement. Culture was positive for methicillin-resistant Staphylococcus aureus. Although the treatment is established, the patient dies after sepsis and failure of vital organs. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done.

Fracture of the Coronoid Process, Sphenoid Bone, Zygoma, and Zygomatic Arch After a Firearm Injury

A rare case of fracture of the coronoid process, sphenoid bone, zygoma, and zygomatic arch caused by a firearm is described. A 25-year-old man was hit in the face with a bullet, resulting in restricted mouth opening, difficulty chewing, and pain when opening the mouth. The clinical examination revealed a perforating wound in the right parotid region. A computed tomographic scan revealed a comminuted fracture of the left coronoid process with the bullet stopping in the intact left coronoid process. Treatment was bilateral coronoidectomy associated with speech therapy and was successful. Details of the clinical signs, computed tomography, treatment, and follow-up are presented.

Adenomatoid odontogenic tumor

The adenomatoid odontogenic tumor (AOT) is usually an asymptomatic slow growth lesion. When grown, one can palpate a hard and large lesion. It is common for the tumor to cause shifting of neighboring teeth because tumor expansion is more common than teeth root resorption. Radiographically, there is a unilocular mass involving an unerupted tooth, sometimes opaque in the center and sclerotic in the periphery. Considering it to be an encapsulated tumor, treatment of choice is enucleation. This paper describes three cases of these tumors and their symptoms, their radiographic characteristics and anatomic findings.

Intraoral approach for removal of large sialolith in submandibular gland.

Sialolithiasis is a benign pathology that occurs most frequently in the submandibular salivary gland due to its anatomic features. Depending on the size and degree of calcification, a sialolith can be visible in radiographic examinations. Patients commonly experience pain and/or edema when the ducts are obstructed. The authors report two cases of sialolithiasis of the submandibular gland after searching for the source of swelling in the submandibular region. The diagnosis was confirmed by clinical and tomographic examinations. Despite the considerable size of the sialoliths, treatment consisted of the removal of the calcified mass using an intraoral surgical approach. The prognosis is often good and there is generally no recurrence of the condition.

Extenso nevo azul intraoral: relato de caso

O nevo e uma ma-formacao congenita pigmentada, raramente encontrado na mucosa bucal. Cerca de 1/3 dos casos localizados nesta regiao anatomica sao do tipo azul, uma variante histologica com consideravel tendencia a malignizacao. Este artigo relata o caso de um paciente do sexo masculino, tabagista cronico, portador de um nevo azul de 5 cm de diâmetro no palato duro. A excisao da lesao sem biopsia previa foi a conduta terapeutica de eleicao para o caso, uma vez que ainda existe controversia na literatura a respeito da realizacao de biopsia incisional em lesoes pigmentadas malignas ou com potencial de malignizacao. O paciente foi acompanhado por um periodo de 2 anos, sem sinais de recorrencia ou transformacao maligna

Iatrogenic infection in dermoid cysts of the floor of the mouth

Doctoral degree in oral pathology, Rio Grande do Norte Federal University (UFRN). Adjunct professor of oral pathology, Pernambuco Dentistry School (FOP), UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco - FOP).Pernambuco University (Universidade de Pernambuco - UPE).Send correspondence to: Thiago de Santana Santos - Faculdade de Odontologia, Universidade de Pernambuco - Av. General Newton Cavalcanti, 1650. CEP: 54753-220. Camaragibe, PE, Brazil. Phone: (+55 81) 345828 - Fax: (+55 81) 34582867 - E-mail: thiago.ctbmf@yahoo.com.brPaper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 4, 2010; and accepted on July 20, 2010. cod. 7063

Nevoid Basal Cell Carcinoma Syndrome: A Long-Term Study in a Family.

We present a family case series with 10 individuals having nevoid basal cell carcinoma syndrome (NBCCS) with a 10-year follow-up. All articles published in the literature between 1967 and 2011 on familial Gorlin-Goltz syndrome in any language were surveyed to determine the mapping of cases per country of occurrence of this disease. All patients in the present series were presented with calcification of the falx cerebri, mild hypertelorism, and frontal bossing. Odontogenic keratocystic tumors, palmar and plantar pits, and multiple basal cell carcinomas occurred in 90, 40, and 20%, respectively, of the patients. One of the patients died of skin cancer. Diagnosis of odontogenic keratocyst tumors was confirmed by histopathological examination. NBCCS is a rare autosomal dominant cancer predisposition syndrome; it is important to recognize it when a patient has multiple odontogenic keratocyst tumors because life-long monitoring is essential for patient management.

Excision of ranula using injection of hydrocolloid dental impression material.

patient was discharged on the third day with enteric-coated aspirin therapy. The tongue mobility was improved with the initial resorption of the sublingual hematoma; however, the patient did not return for follow-up. The tongue is a generously perfused structure supplied by the lingual artery and its sublingual, deep lingual, and dorsal lingual branches. Extensive hemorrhage from the lingual artery may occur after traumatic injury. Hemorrhage into the tongue has been reported after the use of streptokinase, heparin, tissue-type plasminogen activator administration, and in hemophilia. Sublingual hematomas leading to upper airway obstruction have also been reported in patients treated with anticoagulants. The most serious case report describes anoxic brain damage and death as a consequence of airway collapse with sublingual hematoma. The current case had an intermediate benign clinical course because of absence of airway obstruction despite the great sublingual swelling. In conclusion, sublingual hematomas are a rare but life-threatening complication of warfarin therapywhere observation, closemonitoring, and reversal of anticoagulation can be a reasonable and successful management option without an articial airway.

Case ReportIatrogenic infection in dermoid cysts of the floor of the mouth

Doctoral degree in oral pathology, Rio Grande do Norte Federal University (UFRN). Adjunct professor of oral pathology, Pernambuco Dentistry School (FOP), UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco - FOP).Pernambuco University (Universidade de Pernambuco - UPE).Send correspondence to: Thiago de Santana Santos - Faculdade de Odontologia, Universidade de Pernambuco - Av. General Newton Cavalcanti, 1650. CEP: 54753-220. Camaragibe, PE, Brazil. Phone: (+55 81) 345828 - Fax: (+55 81) 34582867 - E-mail: thiago.ctbmf@yahoo.com.brPaper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 4, 2010; and accepted on July 20, 2010. cod. 7063