Odontomas in pediatric dentistry: Report of two cases

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

Periodontal plastic surgery associated with treatment for the removal of gingival overgrowth

Background: Excisional biopsies of gingival overgrowths, performed with safety margins, frequently result in mucogingival defects. These defects may produce esthetic problems and increase the chances of dentin hyperesthesia and its possibility of hindering oral hygiene. Methods: Two clinical cases are reported in which gingival overgrowths were removed by excisional biopsy, resulting in unsightly defects. The first clinical case presents an invasive approach for the treatment of a recurrent pyogenic granuloma in the anterior maxilla, and the second depicts a complete removal of a peripheral odontogenic fibroma in the posterior maxilla. In both situations, the soft-tissue defects were repaired by periodontal plastic surgery, including a laterally positioned flap and a coronally positioned flap, respectively. Results: Periodontal plastic surgery successfully restored the defects that resulted from biopsies, and no recurrence has been noticed in the 5-year postoperative follow-up period. Conclusions: The combination of biopsy and periodontal plastic surgery in a one-step procedure seems to be suitable to remove gingival overgrowths in most areas of the mouth, regardless of esthetic significance. Such procedures seem to restore gingival health, encourage healing, and create both esthetics and function in the excised area.

Dentigerous cysts in primary dentition: Report of 2 cases

Dentigerous cysts are benign odontogenic cysts associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. The purpose of this case report was to describe the management of 2 dentigerous cysts in children. The treatments instituted were the extraction of the deciduous tooth involved followed by marsupialization in the first case and enucleation in the second one. Both treatments allowed rapid healing of the lesion and eruption of the permanent teeth without the need for orthodontic treatment.

Unusual wooden foreign body in the palate

We report a case of a palatal calcified foreign body simulating an odontogenic lesion. Surgical exploration revealed a calcified mass that was analysed under light microscopy and identified as a vegetal foreign body. Further scanning electron microscopy analysis revealed that the foreign body was a piece of wood. Hard palate foreign bodies have been reported previously, however, it seems that this is the first case of its kind. © 2007 Nature Publishing Group.

Florid cemento-osseous dysplasia: A report of three cases

Florid cemento-osseous dysplasia (FCOD) is a non-neoplastic condition of the jaws that Is not associated with inflammation of the pulp or periodontal tissue. This article reports on three cases that were diagnosed as FCOD, demonstrating the importance of both clinical and radiographic diagnosis and the clinical management of these lesions.

Transformação cística como consequência de terceiro molar inferior incluso

The permanence of impacted third molar in the jaws can cause many pathological alterations, amongst them the appearance of odontogenic cysts. The paradental cyst appearance and evolution next to a mandibular included third molar was diagnosised in radiograph routine follow-up, and its evolution and treatment are described. Are discussed the aspects related with the preventive removal to the impacted third molars and the necessity to institution a plan of treatment based in clinical history and radiograph in order to establish a preventive protocol the alterations caused by these impactions. The indication of extraction of impacted third enclosed can be a way to preventing the appearance of these and otherspathologies associates to these lesions.

Noninvasive aspergillosis as a maxillary antrolith: report of a rare case.

Maxillary antrolithiasis is characterized by masses of tissue of endogenous or exogenous origin that calcify within the maxillary sinuses. Aspergillosis is a fungal disease in which the maxillary sinus is a primary site of infection. Aspergillosis mycetoma, its noninvasive form, is the most prevalent modality of the disease in the maxillary sinuses. In approximately half of the cases reported in the literature, calcification of the fungal mycelia, which later became antroliths, was verified. This article reports a rare case of the accidental discovery of a maxillary antrolith associated with noninvasive aspergillosis in an immunocompetent and asymptomatic 56-year-old woman. The diagnosis and therapeutic procedures used in treating the patient are discussed as well as the probable iatrogenic origin of the fungal pathology.

The challenges of treating a fused tooth

This paper describes and discusses the multidisciplinary treatment involving a permanent maxillary lateral incisor fused to a supernumerary tooth, both presenting pulp necrosis and periapical lesion. A 15-year-old male patient sought treatment complaining of pain, swelling and mobility on the maxillary right lateral incisor. After clinical and radiographic examination, root canal preparation was performed according to the crown-down technique and a calcium hydroxide dressing was placed for 15 days. The patient returned and the definitive endodontic filling was done with thermomechanical compaction of gutta-percha and sealer. After 18 months, clinical and radiographic examinations were carried out and no pain or swelling was reported. Two years after endodontic treatment, the patient returned for periodontal and cosmetic treatments. Nine months later, a cone-beam computed tomography (CBCT) revealed that the previously detected periodontal defect and periapical lesion were persistent. Apical endodontic surgery was indicated. The supernumerary tooth was removed, the communicating distal surface was filled and the surgical site received bioactive glass and demineralized bovine organic bone. The pathological tissue was submitted to histopathological examination and the diagnosis was periapical cyst. One year after the apical endodontic surgery, CBCT showed bone formation at maxillary lateral incisor apical area. Two years after the surgery, the restoration was replaced due to aesthetic reasons and periapical radiograph showed success after 5 years of treatment. A correct diagnosis and establishment of an adequate treatment plan resulted in a successful management of the case.

Ameloblastoma mandibular rostral em um cão

Odontogenics tumors are uncommon in the dog. Ameloblastoma is considered a benign, aggressive and non-inductive odontogenic neoplasia commonly located in the incisor teeth. Its conclusive diagnosis is obtained by histopathological examination. Due to the expansive nature of this neoplasia, its resection needs to have an adequate surgical margin so it will have excellent prognostics. A canine, male, Pekingese, 8 years old had an increased volume in the rostral region of the mandible, adhered, consistency moderately firm. Radiography revealed extensive mandibular bone lysis caused by the neoplasia. Biopsy identified the tumor as ameloblastoma. Combining data from the clinical, radiographic and histopatological study and after explain to the owner regarding the postoperative esthetic it was held a bilateral rostral mandibulectomy. The fragment removed was assessed radiographically and histopathologically for evidence of tumor at its edges. The patient is active and healthy without evidence of metastasis or recurrence. The radiographic and histopathologic evaluation of edges of the fragment showed no tumor evidence. The patient is active and healthy without evidence of metastasis or recurrence since January 2010 when mandibulectomy was performed.

Five-year follow-up of modified implant-supported overdenture in an iliac crest autograft failure: Clinical report

The treatment of extensive pathologic lesions in the jaw, most of the time, can generate rehabilitation problems to the patient. The solid ameloblastoma is a locally invasive odontogenic tumor with a high recurrence rate. Its treatment is aggressive and accomplished through resection with safety margin. The criterion standard for reconstruction is autogenous bone, but it can provide a high degree of resorption, causing inconvenience to the patient because of lack of rehabilitative option. This study aimed to describe a patient with ameloblastoma treated through resection and reconstruction with autogenous bone graft, in which, after an extensive resorption of the graft was made, a modified bar was applied to support a prosthetic implant overdenture. Copyright © 2013 by Mutaz B. Habal, MD.

Terapêutica medicamentosa em odontologia: antibióticos

Pós-graduação em Odontologia - FOA

Estudo clínico, imaginológico, histopatológico e imunohistoquímico de ameloblastomas submetidos à descompressão

Pós-graduação em Odontologia - FOA

Estudo comparativo entre o tumor odontogênico adenomatóide e tumor odontogênico epitelial calcificante a partir da técnica histoquímica do AgNOR e da imunohistoquímica do PCNA, p 53 e Ki-67

Pós-graduação em Odontologia - FOA

Conservative Approach: Using Decompression Procedure for Management of a Large Unicystic Ameloblastoma of the Mandible

Ameloblastoma is a relatively uncommon benign odontogenic tumor, which is locally aggressive and has a high tendency to recur, despite its benign histopathologic features. This pathology can be classified into 4 groups: unicystic, solid or multicystic, peripheral, and malignant. There are 3 variants of unicystic ameloblastoma, as luminal, intraluminal, and mural. Therefore, in mural ameloblastoma, the fibrous wall of the cyst is infiltrated with tumor nodules, and for this reason it is considered the most aggressive variant of unicystic ameloblastomas. Various treatment techniques for ameloblastomas have been proposed, which include decompression, enucleation/curettage, sclerotizing solution, cryosurgery, marginal resection, and aggressive resection. Literature shows treatment of this lesion continues to be a subject of intense interest and some controversy. Thus, the authors aimed to describe a case of a mural unicystic ameloblastoma of follicular subtype in a 19-year-old subject who was successfully treated using conservative approaches, as decompression. The patient has been followed up for 3 years, and has remained clinically and radiographically disease-free.

Fatores prognósticos e análise de sobrevida de pacientes diagnosticados com carcinoma espinocelular nos 10 primeiros anos do Centro de Oncologia Bucal da Unesp, Campus de Araçatuba

Objetivo: Estimar as probabilidades acumuladas de sobrevida dos pacientes diagnosticados com carcinoma espinocelular nos 10 primeiros anos do Centro de Oncologia Bucal da UNESP, Campus de Araçatuba, de 1991 a 2000, observadas até 2005, estabelecendo os possíveis fatores prognósticos significativos para o óbito. Méttodo: A análise de sobrevida foi realizada em uma coorte de 280 pacientes com carcinoma espinocelular, no Centro de Oncologia Bucal da Faculdade de Odontologia de Araçatuba, UNESP, entre 1991 e 2000. Para avaliar a associação entre as variáveis independentes e o óbito, realizou-se o teste Log Rank. A probabilidade do teste com p-valor menor que 0,25 ficou estabelecida para a inclusão das covariáveis no processo de ajustamento do modelo. A sobrevida foi estimada pelo método de produto limite de Kaplan-Meier. Os fatores prognósticos foram estimados pelo modelo de riscos proporcionais de Cox, calculando-se razão da função de risco (HR). A análise de resíduo foi realizada para verificar o ajuste do modelo. Resultados: As taxas de probabilidades acumuladas de sobrevida de 280 pacientes, para os casos em estádio IV, foram, 56,74%, 32,13%, 23,71% e 20,57%, respectivamente, até 1, 2, 3 e 5 anos após o diagnóstico. Pacientes no estádio I apresentaram sobrevida em 5 anos de 81,73%. O estadiamento clínico da doença no diagnóstico foi o único fator prognóstico definido no processo de ajuste de modelo. A estimativa da razão da função de riscos de morrer em pacientes diagnosticados no estádio III (HR=3,3), é praticamente três vezes o risco daqueles em estádio I; da mesma forma, o risco de morrer dos diagnosticados em estádio IV (HR=6,17) é cerca de seis vezes ao daqueles em estádio I. Conclusões: A covariável que permaneceu no modelo final foi estadiamento clínico no momento do diagnóstico, sendo, pois, o único fator prognóstico.