Diode laser on excision of giant peripheral odontogenic myxoma: a rare case report and literature review

It was to report a rare case of peripheral odontogenic myxoma removed with high-power diode laser and to do an extensive review of studies of odontogenic cysts and tumors treated with high-power laser (HPL). This is a rare case of a 63-year-old male patient with a peripheral odontogenic myxoma measuring approximately 10 cm in the attached gingiva region of tooth 16 removed with a high-power diode laser (808 nm, 3 W, in continuous mode, under constant suction, with 400-µm optical fiber). A literature review was also carried out looking for articles that involved the use of HPL in the treatment of odontogenic cysts and tumors, without restriction of year or language. In the present case, there was no need for suturing, no postoperative discomfort, and minimal bleeding during the procedure. In a 12-month follow-up period, there were no signs of recurrence. Only two cases of intra-osseous odontogenic myxomas treated with HPL and 10 cases involving other odontogenic cysts and tumors were found. All studies showing HPL to be effective in treating these lesions. Despite the different types of lasers used and different parameters, it is observed that lasers are effective in the treatment of odontogenic lesions.

The use of high and low power lasers in the treatment of mucocele in lip: a case report

Mucocele is an inflammatory lesion of the common salivary gland in the oral cavity, generated by the accumulation of saliva, from the rupture of the minor salivary gland duct. The objective of this report was to describe a case of extravasation phenomena treated with high-power diode laser in association with photobiomodulation. The patient presented a nodular, exophytic lesion on the lower lip, similar in color to the mucosa, measuring 2 cm in diameter. Excisional biopsy was performed with high-power diode laser. Immediately after surgery and weekly thereafter, photobiomulation was performed with lower-power diode. After one-month, total repair of the surgical wound was observed, with minimal scarring, without lesion recurrence during 14 months of follow-up. Therefore, the treatment protocol used proved to be an effective, safe and fast alternative, bringing greater comfort to both professional and patient during the trans and postoperative periods.

Treatment of recurrent herpes of the lower lip skin region with photodynamic therapy and photobiomodulation: case report

The aim of the present study is to describe a case report on the treatment of recurrent herpes using Photodynamic therapy (PDT) and Photobiomodulation as the treatments of choice. A 21-year-old white man checked in in the clinic for evaluation of vesicles arranged in the lower lip skin region. The clinical diagnosis was recurrent herpes and, for treatment, PDT was chosen, using 0.1% methylene blue as a photosensitizer and a pre-irradiation time of five minutes. The Therapy XT laser was used, with a wavelength of 660 nm, power of 100 mW, in a spot area of 0.028 cm², using 4 J energy per point, having been applied on 4 points, one in the center of the lesion and three on its laterals, so that it involved the entire extension of the lesion, totaling 16 J. After 24 hours after the application of the PDT, the patient returned for photobiomodulation with a low-power laser with a wavelength of 660 nm, power of 100 mW, using energy of 1 J per point, for 10 s, being applied on 4 points, totaling 4 J. It was possible to observe complete healing after 10 days of treatment, and the patient remains in follow-up for eight months without any recurrences.

ILIB (intravascular laser irradiation of blood) as an adjuvant therapy in the treatment of patients with chronic systemic diseases-an integrative literature review

To perform an integrative review of the literature on the effectiveness of intravascular laser irradiation of blood (ILIB) as an adjunct therapy in the treatment of chronic systemic diseases. This is an integrative literature review that included non-randomized and randomized controlled clinical trials that specifically evaluated the therapeutic effect of ILIB on chronic systemic diseases, without restriction of time, and written in English. The Medical Publications (PubMed)/MEDLINE database was used. MeSH (Medical Subject Headings) was used to select search descriptors with the Boolean operators "AND/OR." After applying the inclusion and exclusion criteria, 13 articles were selected. Coronary diseases were the most prevalent, followed by type 2 diabetes mellitus, with the coronary artery being the most widely used access route for ILIB application. Despite the varied parameters and protocols for using this kind of therapy, all studies have shown satisfactory results in the patients' clinical condition. ILIB proved to be effective in all organic systems, showing some positive result. However, studies on the effect of this therapy on various diseases are still scarce in the literature, and there is a need for more well-designed clinical trials to better understand the role of ILIB in various systemic diseases.

Pleomorphic adenoma of buccal mucosa: a case report and review of the literature

BACKGROUND

Salivary gland neoplasms are rare, accounting for 3% to 5% of all head and neck tumors, and involvement of the minor salivary glands is uncommon. Pleomorphic adenoma (PA) is the most common benign neoplasm, which mainly affects the parotid gland. However, involvement of the cheek mucosa is very rare.

OBJECTIVE

This study reports a case of PA in the cheek mucosa. In addition, the etiopathogenesis, clinical and morphological features and differential diagnoses of PA are discussed, emphasizing the importance of knowledge about the characteristics of this tumor for a correct diagnosis.

CASE REPORT

A 50-year-old woman presented with a nodular lesion of endophytic growth in the left cheek mucosa. The lesion was small and well-delimited and had a normal mucosa color and intact surface. An excisional biopsy of the lesion was performed, and the diagnosis was PA.

CONCLUSION

Although the occurrence of PA in the minor salivary glands of the cheek mucosa is uncommon, the early establishment of a correct diagnosis and initiation of appropriate treatment are important because they permit effective management of the condition and improvement in the prognosis of patients.

Antibacterial Effect of Photodynamic Therapy on Root Canal Disinfection Combined with Different Irrigation Protocols

Introduction

Photodynamic therapy (PDT) is an emerging alternative therapy to conventional endodontic treatment to optimize bacterial elimination. The aim of this study was to evaluate the in vitro antibacterial effect of PDT combined with different irrigation protocols on root canals inoculated with Enterococcus (E.) faecalis.

Methods and Materials

Ninety uni-radicular human premolars were prepared and contaminated with E. faecalis for 4 days. Teeth were randomly divided into six groups: positive control group (C+) consisted of conventional needle irrigation with 2.5% sodium hypochlorite (NaOCl); negative control group (C-) consisted of no treatment after contamination; PDT group as treated with 0.005% methylene blue and diode laser irradiation for 90 sec at wavelength of 660 nm, energy of 9 Joules, power of 100 mW; the fourth group consisted of NaOCl+PDT, the fifth group were treated with passive ultrasonic irrigation (PUI) with NaOCl+PDT (PUI+PDT); and the final group were treated with XP Endo Finisher with NaOCl+PDT (XP Endo+PDT). The contents of the root canals were collected with sterile absorbent paper points at two times: before and 24 h after decontamination protocols. The number of colony-forming units (CFU) was determined for each root canal. ANOVA and the Tukey test were used, with significance set at 5% (P<0.05).

Results

The inhibition percentage ranged from 10.72 (C-) to 100% (XP Endo+PDT), with CFU/mL counts differing among all protocols tested (P<0.05). The different protocols significantly influenced bacterial inhibition (P<0.05). However, the XP Endo+PDT protocol resulted in the highest inhibition percentage (100%), followed by NaOCl+PDT (65.85%).

Conclusions

PDT combined with different final irrigation protocols was more effective in inhibiting E. faecalis growth than photodynamic therapy alone. XP Endo was the best irrigation protocol to eradicate this microorganism.

Clinicopathological and immunohistochemical analysis of spindle cell squamous cell carcinoma of the tongue: a rare case

Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed. Histopathological analysis showed a proliferation of atypical spindle cells, exhibiting extensive pleomorphism. Tumor cells were positive for vimentin, P53 and alpha-smooth muscle actin, focally positive for epithelial membrane antigen and P63, and negative for pan-cytokeratin (AE1/AE3), CK7, CD138, CD34, CD56, and S-100. The positivity index for Ki-67 was approximately 40%. The diagnosis of spindle cell squamous cell carcinoma was established and the patient was referred to a head and neck surgery service. In the oral cavity, spindle cell squamous cell carcinoma of the tongue is an aggressive variant of squamous cell carcinoma, which usually presents as an exophytic mass located on the tongue of elderly males. Due to its distinct histopathological characteristics, immunohistochemistry is a valuable and helpful tool to establish the diagnosis of spindle cell squamous cell carcinoma of the tongue.

Prototyping for the treatment of late zygomatic-orbital fracture: A case report

INTRODUCTION

Zygomatic-orbital complex fractures are the most common facial traumas that can result in severe esthetic and functional sequelae. Surgical correction of these fractures is a delicate approach and prototyping is an excellent tool to facilitate this procedure.

PRESENTATION OF CASE

A 27-year-old man, a motorcycle accident victim, was hospitalized in the intensive care unit for 30days. After this period, facial fractures were treated surgically, leaving sequelae such as enophthalmos, dystopia and loss of projection of the zygomatic arch. A second intervention was planned after one year for reconstruction of the orbit with the help of prototyping. Better outcomes were achieved than in the first intervention.

DISCUSSION

This report permits to compare the result of conventional surgery and the use of a prototype in the same patient. Noticeably better outcomes were achieved with the second approach. Prototyping made the surgical procedure more predictable and reduced operative time because of the possibility of using preshaped titanium plates.

CONCLUSIONS

Prototyping was found to be an excellent option to overcome the deficiencies of the conventional technique, recovering the functional and esthetic characteristics of the patient's face and ensuring a markedly satisfactory outcome.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2

BACKGROUND

Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth.

OBJECTIVES

To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus.

METHODS

A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression.

RESULTS

The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model.

CONCLUSIONS

The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2.

Aspectos demográficos e manifestações clínicas bucais de pacientes soropositivos para o HIV/Aids

INTRODUÇÃO: As lesões bucais e peribucais são comuns nos pacientes infectados pelo vírus HIV e podem representar os primeiros sinais da doença, antes mesmo das manifestações sistêmicas. OBJETIVO: Este estudo objetivou estimar a prevalência de manifestações bucais em indivíduos soropositivos para o HIV, considerando aspectos sociodemográficos, imunológicos e terapêuticos. MATERIAL E MÉTODO: Foi realizado um estudo de natureza clínico-epidemiológica transversal, entre outubro de 2007 e abril de 2008, com amostra composta por 40 pacientes. Utilizou-se a técnica de observação direta intensiva por meio de exame clínico apropriado. Os dados foram registrados em fichas pré-elaboradas e analisados por estatística descritiva e inferencial. RESULTADO: Verificou-se a prevalência do gênero feminino (52,5%), na faixa etária de 40 a 49 anos (45%). O tratamento com antirretrovirais foi constatado em 85,0% dos casos, sendo todos com terapia de alta potência (HAART). Observou-se que 52,5% dos pacientes apresentaram a contagem de linfócitos TCD4+ acima de 500cél/mm³ e 50,0% apresentaram carga viral indetectável. A prevalência das manifestações bucais foi 42,5%, sendo a mais expressiva a candidose pseudomembranosa (19,23%), seguida da periodontite úlcero-necrosante (15,38%), da leucoplasia pilosa (11,54%) e da queilite angular (11,54%). Não foi verificada associação entre manifestações bucais e carga viral (p=0,1268), nem com o número de células T CD4 (p=0,3458). CONCLUSÃO: A prevalência de algumas manifestações bucais associadas à infecção pelo HIV ainda é alta, sendo a candidose pseudomembranosa a infecção mais prevalente, principalmente entre pessoas com baixo nível de escolaridade e maior tempo de infecção pelo vírus HIV, independentemente da terapia utilizada e do estado imunológico do paciente.

Adenoid cystic carcinoma mimicking an oroantral fistula: a case report

Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis.

Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula.

Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up.

Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.